Terrible Confusion

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I'm probably not going to be able to find the correct words or way to say what I'm trying to say and I'm sorry for that. I don't even think I've gathered all my thoughts yet.

Yesterday, I had therapy and it wasn't awful but I left with a lot on my mind. There was one point near the end when she looked down at the notes she'd been taking and commented on the variety of symptoms I display. I don't remember her exact words but I felt like it was a "holy crap" moment. She basically reaffirmed some diagnoses that have been established, but when they were all voiced at once, I realized how overwhelming it was. Major Depressive Disorder, Anxiety, Aspergers, OCD, and she said that she isn't quite sure if she saw Mania or ADHD in the mess of symptoms. My last therapist focused a lot on my PTSD, but I've not talked about it much with this therapist, so that's why it wasn't mentioned in the list based on the symptoms we discussed that day.
Hearing it like that felt very overwhelming. I know what all this feels like and I've always felt weighed down and crushed by everything, but to hear it aloud was just weird.

She asked what I'd like to start addressing and I had no clue what to say. I don't know where to start, so I have no opinion on that matter. She also said that she feels like I don't want to work on things even though I know there are problems. She asked if I was happy with where I'm at in life and of course my answer was no. I tried to explain how I'm too beat down and exhausted to work so hard on things right now. But, I couldn't explain it because I can't understand it myself. I can't answer the questions about what is wearing me down and taking up my energy. I don't know really. I think part of the reason I'm avoiding working on things too hard is because I know how awful it's going to make me. I know that if it's anything like it always has been, I will go to a worse place emotionally and mentally. I'm afraid of that. I am too depressed right now to do anything, including focusing on special interests. I have no interest in people right now. I had been interested in working on social interaction, but I don't have a desire to right now because I don't really know if I care about emotional connections with people because I've never been able to make any. I don't know if I care about being able to go out and do things that anxiety keeps me from doing because I don't see the point in those things. They seem like a waste of time. I don't understand how going to movies or to sporting events is supposed to be a good thing, a fun thing, to do.

Can anyone relate to this? Is it common to not be able to explain the reasons that, at times, you don't feel capable of working on things? Does anyone else find it almost impossible to make connections with people and feel emotion towards them? Like, I care about people in the sense that I can see good qualities in them, even if they add nothing to my life I can appreciate their existence, and I love people in the sense that I will do what is good for them and commit my will to their true good, but I don't feel love. I'm assuming it's normal to not have the slightest clue what you need, want, and are supposed to be doing.

Any advice on what I can say to my therapist next Monday in order to expound on and clarify those questions and answers that were dealt with this past Monday?

Yes. I think I can relate, and you have worded things much better than I ever could have.

This might not be what you want, but do you think it would help if you printed/copied out this post, and showed it to her?

I don't think I can bring myself to copy out this post, but I guess writing a few sentences to remind myself of bringing these things back up next time might be a good idea. I'm very forgetful sometimes.

When everything is overwhelming, I need to stay in the moment. For me, that would mean identifying whether I felt worse or better after I left than before I went.

Also strong feelings can be confusing to try to communicate, therapists sometimes misinterpret confusion and difficulty communicating what one feels as intentional and as lack of motivation. A good therapist can learn to or knows how to help structure the communication so that your anxiety is lessened and that can really help with communicating and forming a positive relationship.

Can you perhaps explain that you are overwhelmed and ask for some help organizing what to focus on? For an Aspie, I think that's a reasonable accommodation for the things that are difficult. Of course it's your responsibility to try to communicate honestly and to accept feedback and consider change.

I could be wrong, but when I read your post about having no idea where to start or what to say, I feel badly, I can think of so many times I've heard the message "just get it together" and that's so hard to do just because someone says so. Asking the therapist for help with where to start and what to say is very reasonable for an Aspie, IMO.

I wonder if this example might help you think things through a bit. I had trouble with my family doctor because I have agoraphobia. I also have PTSD and general depression. But the doc misunderstood my agoraphobia, which is a *side-effect* of my PTSD and not classic agoraphobia. So her treatment ideas were counter-productive.

Does that make any sense? Is it possible that your symptoms are not several different diagnoses, but only several different manifestations of one diagnosis?

For example, I think it's a pretty fair bet that most people with PTSD are depressed. I'm trying to say that you might search for a root cause for all these symptoms.

Your therapist sounds odd - she reads off all those things and wants you to be enthusiastic about treatment (or anything, for that matter)?

My own best help for PTSD is EMDR, fwiw.

My very best to you. Don't give up and don't get snowed under. And keep coming back - don't get isolated! We're here for you.