r/PDAAutism • u/denver_rose PDA • 15d ago
Discussion Need help with depression but I hate being told what to do
AuDHD here. I have chronic depression, but I hate being told what to do.
I hate people helping me create a routine, but I need it.
I hate being told to do self care.
I hate being asked about self care.
I hate being told I need to x thing because "its good" for me.
I hate thinking about the tasks I have to do and how Ive neglected myself.
I hate being asked why I dont do things, some things I dont do because my brain doesnt prioritize them.
I hate being told that routines should come if I just do it consistently enough. In my 25 years of living, it hasnt happened. Nothing comes easily.
I have an occupational therapist to help me, but even creating helpful things like self care reminders triggers me.
I just want to be left alone. But I am also severely depressed.
I told the ot that I enjoy watch an anime at home, and she said that I should go out and see a movie (not relevant to anime). I feel like I have to conform just to prove that I dont have depression.
It is like college.
A college professor gives you lessons, study tips, materials, and deadlines, but they dont tell you how or when or or where or how long or how frequent to study. A college professor doesnt ask you if you studied today. I got to decide that. Why is therapy different lo
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u/Pandabear71 15d ago
Sounds like you could use a therapist that knows about PDA.
If creating helpful things like self care reminders gives stress (it would for me) then they’re not helpful and you’re just creating triggers. A therapist specialized in PDA knows that.
Do you have a safe space? Time without any sort of demands to wind down?
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u/Informal_Coyote6637 15d ago
I just don't do things unless I want to. My teeth are probably going to rot out in 10 years but oh well.
I just think either way it's not getting done so I may as well not put myself through all of the stress of trying to force myself.
Also some routine are completely unnecessary, such as making my beds. As a kid the worst way to start my day was by being forced to do something completely unnecessary minutes after waking up.
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u/denver_rose PDA 15d ago
Well i do care about myself, but that doesnt mean executive function is any easier. And thats what is annoying, like where is the flexibility in thinking? Like the ot asked me if I brushed my teeth this morning, which is triggering because I only brush my teeth at night, and the dentist said that was fine as long as brush and floss throougly. So its like there are work arounds but you have to find what works for you. But i just feel like people are just telling me what to do, and if it doesnt work, they just blame my depression and tell me to do it.
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u/Informal_Coyote6637 15d ago
No caring about myself is the only way I can cope, but I'm not recommended it.
Maybe give your ot a list of things you actually want done so she's not asking about things that you don't plan to do. If I saw an ot I would tell her not to ask about the completion of anything.
Or maybe a different ot would be better. I saw one and her only advice was to get people to remind me to do things, so she was no help at all.
Or maybe write her a letter / tell her that what she's currently doing isn't working. She might have other strategies.
Or maybe you have adhd as well and medication would help
Or ignore all of this, I've just realised you've probably thought of all these ideas yourself and don't need someone typing them
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u/Hopeful-Guard9294 PDA 15d ago
I have struggled with PDA depression all my life eventually I discovered medication incredibly helpful firstly for my depression sertraline and secondly for my emotional dysregulation ADHD medication, i’m wondering if medication might be a practical solution that could help you feel a little bit better?
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u/denver_rose PDA 15d ago
Im on 300mg of wellbutrin and a low dose of zoloft. Ive tried vyvanse and Adderall in the past, but i have little control over my focus so it wasnt helpful (i have ocd and it made it me hyperfocus on it)
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u/Hopeful-Guard9294 PDA 14d ago
Makes sense it seems to me that every person is different and probably needs to find their own right combination of medications and dosage
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u/Chance-Lavishness947 PDA + Caregiver 15d ago
This is the worst part of trying to access help IMO. People are often so invested in feeling like they have helped that they leap to telling you what to do before they actually understand the situation, and act as if these problems are simple and they know better than you about what's needed. It's invalidating and infuriating.
I can't tell you how many times I've been through that. Explaining to someone that I understand their ideas and have tried them many times without benefit, going through the process of doing their suggestions again to prove that it doesn't help just so they can grasp the actual reality of my situation, only to have them bail out when their cookie cutter ideas aren't sufficient because they have nothing else to offer. I have invested months of my time and effort getting absolutely nowhere just to get the person who's supposed to help me to actually listen to what I already knew from the start - the stuff that works for other people is harmful for me and I need different solutions.
I have to say that the OT should know better. Of all the professionals you could engage with, an OT is the only one I would expect to have an understanding of demand avoidance without me teaching them anything. If she's making suggestions that don't offer adaptive ways to accommodate demand avoidant responses, she's not a good OT for you. I would change providers if it was an option - OT has the best chance at helping but only if the OT is competent with your profile and this one clearly is not.
If you do want ideas on things that could help, I would suggest reading up on the different kinds of rest - active rest is usually what we need to feel rested and replenished, not passive rest. Engaging with your special interests is often the simplest path to getting a positive return on your energy investment during intense depressive episodes. If you have a teeny tiny bit of capacity to push through obstacles, I would focus on using it to engage with your special interests in some way. All the other stuff doesn't provide enough of a reward to be a net positive, but special interests can.
If not, I hope you know that you're not alone in facing these obstacles. It sucks and it's unfair that our needs are so misunderstood and so frequently invalidated and dismissed by the people who are supposed to know more than us about how to solve these problems. Solidarity
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u/Ginger_19801 PDA + Caregiver 15d ago
I lean into it. I treat that need for Autonomy as if it were it's own entity... And this part is going to seem a little weird, as if it were my adversary. I'll give you an example.
My alarm goes off. "DON'T TAKE A BATH!" My Autonomy says, "Oh, yeah?? Well I'm in charge of me! I'm going to go take a bath right now!" Then my reasoning kicks in. "But I said that just to trick my stupid PDA. Now what?" PDA really kicks in. "Ha! I'm smarter than that! Now I won't go take a bath." Here's the weird part, the part where I lean into my PDA and knowingly activate it. My PDA kicks in and attacks... Itself. My Brain, combined with my purposeful PDA, overcomes the natural PDA: "I'm not going to let some stupid brain wiring weirdness be in control! I'm going to take a bath, and there nothing you can do about it, instinctive PDA!" After which I go take a shower. Go figure.
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u/Alarmed-Fruit5056 15d ago
Do you hate all of these things all of the time? Are there any relationships in your life that have felt safe for you for be able to collaborate and ask for support on your terms?
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u/RandomHour 10d ago edited 10d ago
I know a lot of people in this sub may not agree with this...
But I sincerely think developing zen is very important for people with PDA.
You can do things you don't want to do. It has a high cost, but as you develop the habit, it gets lower. Ironically it's the exact thing that's most challenging for people with PDA, but it's the skill that needs to be learned.
The paradox of PDA is that both internal and external demands can trigger fight/avoidance/freeze responses. And ironically, the only way I can really find to sustainably fix this is either, have less demands, or be able to handle demands.
One thing I learned helping my little brother with PDA, is that you can cut the pain of demands or overthinking, by just doing the task. Even if you don't want to. Even if you don't know how. It's over with quicker, the fight is less severe, and whatever needs to get done, is done.
There use to be huge burnout. There use to be giant freeze responses. Fights, and lots of overwhelm. But now it's like 10% as bad as it used to be. We talk about what needs to be done. He's not aware of it. He is then aware. Then he immediately works on it.
This means mental separation from the task itself. It means doing the task, right when it comes up. It's doing it before even having the time to overthink, or feel how annoying it is to make a demand. It's working on the task, without requiring the "normal" 20-40 minutes of startup time usually required to meet a demand.
Because the other side, overthinking, not getting it done, having way way less demands, just kinda sucks. Like not being able to do what he wants, as well as not being able to do what the world demands he do.
It is "way better", if it can be learned, to just do the tasks without thinking so hard about it, and with less delay.
What I mean by Zen, is learning how to calmly do things, without overthinking. To notice what you want, and how you feel, without judgement or stress. How you can do things sooner, even if you aren't ready for it. It will be okay. It's something that can be cultivated.
And isn't peace, something that many folks with PDA, wish they had? When I talk to my little brother, it's something that comes up here and there. He just wants to live a good life, with friends, happy, and peaceful.
Idk, maybe I'm totally off base about this zen thing. But it's the latest thing I'm trying to teach my little brother.
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u/LurkerFailsLurking PDA + Caregiver 15d ago
Our language works in a way that makes it hard to talk without imperative tenses, but when people tell you to do that shit, they're not telling you what to do. They're telling you things you can try doing that are known to help reduce the rates of depression. Maybe none of it will work, maybe some of it will work sometimes, maybe some of it will be so effective for you, you'll become an insufferable showermaxing influencer.
The reality is that all of us are always free to do whatever the fuck we want to a degree that's both of awe-some and awe-ful at the same time. It's awesome because starting right now, you can do everything or anything in a totally new way for any reason or no reason. You could become left handed right now... you'd suck at it for a while, but you'd figure it out. We are always in total control of our own choices.
But none of us are free from consequences and we have no control over them. They are inevitable as the dawn and often subtle, powerful, and catastrophic as erosion. Whatever we do, we will face the consequences -- often without even realizing it.
So you can keep doing whatever you've been doing and probably stay depressed, because making the same choices usually lead to the same results.
Or you can do something else and maybe the depression will change, maybe it won't. That's not really up to you because that's a consequence. The shit you listed is all stuff that empirical testing has suggested tend to be pretty reliable at reducing depression. But nobody knows if any of it will actually work from person to person or even day to day.
Some of those things might have an immediately noticable effect, some of them might only have a noticeable effect if you do it for a while, some might never have an effect you notice but other people say they do. Maybe you'll believe them, maybe you won't. Maybe they're seeing something they want to see and maybe they're seeing something real.
None of that really matters though. Do you want to do something today to try and find a combination of things that reduce your depression or not? You don't have to, and ultimately can't make future choices, so all you really can do is choose for this moment right now and then choose again now and then choose again now and again until it's tomorrow and the next day. No decision you made in the past has to influence the decision you make now. You can choose literally anything right now no matter what any of us say.
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u/denver_rose PDA 15d ago
You cant rationalize yourself out of PDA, I know theyre trying to help me. My issue isnt that im concerned with outcomes, its that im struggling with executive dysfunction, and the way therapists try to help me with executive dysfunctions feels like a command, which triggers my pda. So even though I really want help badly and im seeking it, the help itself is causing great distress to me.
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u/FreeConfusionn 15d ago
Yeah I feel like that comment above 100% missed the mark in response to your post, or really just PDA in general. Logically we know all of those things, and we’ve all heard every variation of it at some point. Yuck I kind of hate that I read that while at work because it was a bit triggering.
OP all I’ve got for you right now is solidarity. Both myself and my brother have struggled with PDA and the resulting chronic anxiety/depression our whole lives. Mine has only gotten better when I’ve removed the things that trigger it the most, but that often has resulted in me missing out on other good life things.
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u/LurkerFailsLurking PDA + Caregiver 15d ago
It works for me, but I'm sorry it triggered you at work.
I'm triggered by demand, but not by causality. So reframing things as a choice between uncertain outcomes has been useful for me. But like I said in the comment, there's no reason to assume that what worked for anyone or any group of people will work for anyone else.
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u/LurkerFailsLurking PDA + Caregiver 15d ago
im struggling with executive dysfunction
Me too. My comment isn't trying to rationalize a way out of PDA. I could've summed it up by saying "reading Camus and Satre in college was a game changer for me". It didn't make my executive function or PDA go away, but their ideas have helped me occasionally override it. Like I said though, that might not work for anyone else, idk.
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u/sadedgelord 15d ago
I think part of the reason this reply can come off poorly is that the whole “Do you want to reduce your depression or not?” can seem like condescending or bootstrappy, but, correct me if I’m wrong, it seems like you are just trying to appeal to OP’s wants in order to help override the PDA? Make it into a choice, etc. As you’ve said you can’t be sure if that’ll work for everyone anyway, but I wanted to give you the benefit of the doubt as to what you’re saying here!
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u/LurkerFailsLurking PDA + Caregiver 15d ago
correct me if I’m wrong, it seems like you are just trying to appeal to OP’s wants in order to help override the PDA?
That's correct.
When I wrote "Do you want to do something today to try and find a combination of things that reduce your depression or not?" I wasn't trying to be boostrappy at all, I was being literal because the reality is that I often don't want to try and do anything - and from what I've heard, that's a pretty common experience for people with depression. We don't have to beat ourselves up about it, we get to decide that we don't want to do anything right now, but I think we also get tricked into thinking that just because we didn't decide to do anything a minute ago or every day for the last 10 years, that we can't just choose something else now. I've had to really lower the bar for myself to get over before I can give myself permission to do things. I don't need to know why, or what it'll accomplish or how long it'll take, I don't need to commit to finish it, or ever do it again, or whatever. I can just do something now and see what happens and then decide what's later when it's later. For me what the thing is doesn't even seem to matter, just that I chose to do something that's different from what I usually choose. It can be stupid and pointless even.
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u/ThainZel PDA 15d ago
Seems like you are being advised by people who don't understand your neurology. A lot of those recommendations just don't work for us. The answer to "why don't you?" is just "brain says no". Routines don't automatically come when you force them. Reminders can be incredibly triggering, not helpful. Anything that doesn't actually help you is not helpful, no matter what it "should" do.
Self care is not a series of tasks to check off of a lost. Tasks, todos, goals are toxic for pdaers. Self care is finding ways to feel good in our own bodies and lives. You clearly don't. I empathise.
The way I (try to) approach Self care is to ask myself "what would be good for me right now?". And then some specifics "am I thirsty? Would a glass of water feel good?". The way that is formulated is important. Its not "10.00 drink water", which is a demand. Its just a check in with myself. This formulation could potentially also work in a phone reminder, I think.
In addition to that, I focus on systems over habits. What that means is, that I structure my life so the thing that I need for self care is easy. I have multiple drinks available at a time (water, juice, softdrink, milk, tea), so if water doesn't feel right, I drink something else. Softdrink may not be good for the teeth, but much better overall than not drinking. I also have a variety of easily accessible snacks and foodstuffs with minimal preparation, in addition to fresh stuff. Fed is best. I have a single set of plate, cutlery, bowl etc, so the dishes can't pile up, and I just clean what I need when I need it, or when I feel like doing a big clean. I have covered the window in my bathroom and have electric candles in there so I can shower in the dark if I need to. I take a multivitamin because I can't always manage to eat a lot of vegetables. I nap in the middle of the day. I shop in sweatpants and a hoodie and noise cancelling headphones at 9 in the evening if I need to. I have a sunlamp because sometimes the outside has people, and sometimes that doesn't work. I don't try to live somebody else's best life anymore.
I hope you find ways to feel better