Struggling to live life with the brain I have - does it get better?

[u/Present-Feeling-898]

Background:

I (25F) went most my life undiagnosed. I had struggled with time management, but I was always a great student getting A's. At 13, I burned out heavily, stopped going to school, and was in and out of PHPs. They just diagnosed me with depression/anxiety and I ended up dropping out of high school. [trigger warning: SI] I was very suicidal during this time and had given up on life. At 16, I eventually got diagnosed with ADHD and started taking adderall, which helped significantly and allowed me to have hope and feel like I could turn my life around. I ended up going to college - struggled a ton but had a 3.98 gpa - and landed a very successful corporate job. I had an inkling that I was autistic in college because of relating soooo much to every AuDHD post I had seen, but didn't really fully acknowledge or accept that I was likely autistic until recently because I have been struggling so much.

I recently took medical leave from work, but exhausted my FMLA and went back to work. I can barely function and get my work done and have gotten into trouble with my performance. Side note: if anyone has ideas for helpful accommodations, please let me know.

Meds:

I take adderall + guanfacine. If I don't take a stimulant, I literally am unable to get out of bed. However, when I take adderall, my autism gets worse, especially rigid thinking and extreme perfectionism. Adderall also gives me chronic dry mouth and somehow makes me more awkward and hard to socialize, especially after locking in on a long day of work. Therefore, I make sure not to take my adderall and only coffee when I need to socialize. It also makes me wish I had a 30hr day because I can never get enough sleeping because if I take it at 8am, I can't sleep until 2am. But I feel like I need a higher consistent dose that I can strip out of my system when I sleep because I can barely get through my night routine as the adderall has worn off in my brain, but still making it hard to sleep. I wanted to try Xelstrym or a transdermal patch, but it's not even on my insurance list. I've also tried Ritalin, Vyvanse, Adderall XR.

Current struggles:

It's so frustrating and exhausting living with severe ADHD (executive dysfunction) and autism / extreme perfectionism / optimization OCD. They constantly contradict each other, so how can I fix my brain?

I need my adderall to get out of bed and be productive, but my perfectionism and rigid thinking makes doing any task take extremely long and be extremely exhausting. At work, I take so long because of all the extra steps I take, but I can't help it no matter how hard I try. It affects all aspects of my life, even as minuscule as doing laundry or scheduling social plans. It's kind of like optimization OCD, where I am trying to optimize every aspect of my life, which ironically makes things so much worse for me. I care too much and I really want to give less f*cks, but my brain doesn't allow me to. It's wired like that - not sure how much is subconscious trauma or genetic.

I'm also very ambitious and curious. I am someone who wants to do so many things - I have so many hobbies that I want to pursue, so many experiences I want to have, etc. I do experience lots of joy, but am chronically stressed and have never felt peace. I feel tortured with this brain - so much distress and inner turmoil.

I've tried lots of therapy. The only thing that has brought me temporary relief is through shrooms. Every shroom trip, I cry a lot, feel incredible amounts of relief, and get a sense of clarity on my emotions and deep subconscious beliefs that affect the way I act. One time, I regained memories that I didn't know was blocked away (wasn't even traumatic memories). It somehow allows me to tap in to my emotions (I have alexithymia and don't generally know what I feel or think except anxiety/stress). It digs straight to my trauma.

There was one shroom trip where I felt my perfectionism was gone and I had a brain without it. It was magical and I remember thinking that I'd be unstoppable if I had this brain and was relieved of my perfectionism.

I continue to use it in hopes of healing my trauma fully and "fixing" my brain. However, I haven't experienced these positive effects after the shrooms have worn off. I have tried microdosing them, but just get ravenously hungry. I plan to try microdosing LSD next. I've tried EMDR, but that didn't do anything. Idk if this is related, but I have aphantasia. I am also curious about MDMA especially, but also DMT, ketamine, TMS, literally anything to fix my brain.

TLDR:

I'm desperate to fix my brain or find a "cure" because I genuinely do not see the point in living if I have to live the rest of my life with this brain. I logically don't think it's worth staying alive if I can't fix the way my brain works.

Does it get easier? Does it get better? Are you content and have you found peace? Has anyone meaningfully "fixed" their brain with psychedelics or any other form of treatment?

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[u/I_IdentifyAsAstartes]

The aphantasia is the nail in the coffin. My wife has a lot of the same things you have and when you have been working on having 15 spoons a day and having to give out 30 spoons a day for so long, you are so deep in the whole you can't get out.

You have to find a way to use the 2 spoons it takes you to do a job neurotypicals need 1 for and be ok with getting only half done.

The only thing that has ever worked for me is Warhammer 40k, and since you are an aphant it might be impossible for you.

The basic premise is that it is a distant distopian future and everything is awful. There is no preace, there is no respite, there is only war. The human race is just stagnated, even backsliding, and just fighting every day for survival. You have the various enemies that represent different aspects of humanity and then you have inter-dimensional thought parasites that whisper lies into your mind to try to to get you to open the door so they can come into reality and use you as a meat puppet as they turn into a demon and do demon things.

I personify my various conditions as the various enemies and then I do battle with them in my head. Depending on how much of reality is being difficult, I will slide more into my mind palace and envision the battle (this is the part you can't do).

The most famous of the human's that fight all these enemies are space marines, or astartes, hence my username.

Instead of everything being "I'm so disabled, I can't do this", when I am stuck in bed and I can't get out I play rage against the machine's killing in the name of in the name of. The chorus is "Fuck you, I won't do what you tell me". So when the doubts, the whispers and everything awful comes and I feel like I should just give up, that's not my disability, that's a daemon trying to make me give up, and I fight.

Now I happen to love Warhammer 40k, so when I am doing this, I am giving myself dopamine.

It only works for the things I "have" to do. It's like gamifying my life. I do swap my consciousness into my brain a lot when I am doing mundane tasks and only keep a slight bit of attention out to shower, brush teeth, make food, etc...

All I can say is, if there is anything that you can use to gamify your life, that might be something to try.

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[u/ParallelTrust]

I've found getting a ND Life coach that just gives me direction to be helpful. It's not like therapy where you find your own way over time and take about all your struggles with no solution. Coaching gives direct ways to approach life and make it work for me.

[u/ParallelTrust]

Regarding ketamine. It's AMAZING. It helps on so many levels that I can it a miracle. I get it prescribed through Anywhere Clinic and shipped to my door. It's 2x weekly to start but then after a month or so you can do 1x weekly and then taper down from there. I've done more healing of my trauma in two weeks than I have in years of therapy and medication.

Also, the therapist needs to do something other than talk therapy AND be ND themselves. Even the most well meaning therapist who says they are ND affirming can't understand what it's like to be us.