How to get out of shutdown

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Hi everyone,

I'm currently pausing my study at university by order of my psychiatrist. After crashing completely six months ago, diagnosed with burnout and depression, I have been treated with Escitalopram (aka lexapro), mirtazapine (remeron), zolpidem (ambien), trazodone... None of them had the desired effect and side effects outweighed the benefits.

Most people consider me high functioning (verbal IQ between 160-170, performance IQ between 120-130).

However: I am so low on energy, I can't cope with anything right now. I shut down after only little stimuli...
I don't know how to cook, how to clean the house, can't go to the store...
I can drive a car, but have to be driven around by someone else. I manage the drive to a location, but shut down so badly I don't dare to drive anymore (too dangerous).
I don't enjoy my special interests anymore, and feel mentally stupid (i think my IQ severely dropped, seriously).

When in shutdown, I can barely comprehend speech, fine motor skills disappear, and I even have trouble moving my body. I can only get out of shutdown by retreating in a dark room, and sleep at least an hour with earmuffs, completely sensory deprived.
Waking up, system rebooted, I function fine.

I am currently experiencing 5-10 full shutdowns a week. I think depression and sensory issues contribute to this.
A few years ago, I managed my life far better and even received a degree from university. I feel like I have become way more autistic.

I want my life back!
I feel trapped in my disabled body and am a burden to my family.

Are there experienced people that can give advice how to break through this cycle of shutting down, recovering soon to be shut down again.
How do you get out of shutdown? I can't always put on earmuffs and sleep, especially when I'm not at home. How do you manage shutdowns when not at home?

What treatment do you suggest?

I can't cope with this for much longer... please help...

Are you able to get any sort of help or assistance?

Oh no... I would so like to say something to help.... Stimming violently and drinking fizzy drinks or eating something chocolaty helped me a little. Stimming worked best but it was exhausting. The only real aay in which to help is a long term break from the stresses. I have had to give up working to try to get myself back as I was experiencing strings of partial shutdowns while in work and I was trying to fend off total shutdowns... I only worked 4 or 5 hours every other day. I had to go to work half an hour early so I could calm down enought to walk from the carpark just outside to the shop as I was stuck lying back in the seat unable to move.

Something I say is to get help. Go and see your doctor or preferably a psycologist or someone. Secondly. Your health is more important, so if you can get on some sort of benefit (If applicable) so you can retreat from the collage or work etc, do so... It may take a long time to recover... But to stay as you are will be disasterous.
As you are at the stage you are in, also, find a very secure place and tell a very trusted person like your Mum or Dad etc... and write down important internet details... So if you do get a breakdown, you don't lose your information and passwords etc. You could put tne passwords in one place and the sites they are for in another... But if you do have a breakdown and lose such information, then somebody you trust can keep them safe for a future date so you can access things. But obviously you need such information to be as secure as possible. So be careful. You may find banks etc to have systems in place so you can explain etc, and they can identify you etc... So you maybe covered from that side of things I would have thought?

I reached a very similar state as you are in except that I am still able to drive. I relax when I drive. But a few days I refused to drive when I was not up to it. I am fortunate to have only ever partially shut down while driving so I can reach a layby safely. If I had ever had a total shutdown while driving I would be seriously concerned, but I know the signs a long time bedore I get them as when driving, for some reason any partial shutdown event comes on me slow...
But when I worked it was the complete opposite as I was constantly hitting anxiety which kept pushing me into a very fragile state. I am still fragile even now and it is two months later... So while the main stress has left so I only have a partial shutdown a few times a day or maybe every other day depending on the days events... It is far better then the mess I was getting in with strings of partial shutdowns and constantly fighting off totally shutting down.

So my advice is to stop and get help.

Dear JSBach - I have groundbreaking news on the treatment front which I hope will assist you. I know of someone who went through the same ... and was in this state, and unable to work for a full year, experiencing as you describe. Meds such as trazodone, citilopram, and prozac. Trazodone was only effective in terms of causing such drowsiness, think so drugged up, that the patient literally made his mind up to fight his way out of the stupor(threw the drug away), said to himself, he was not going to feel that way for a further minute. Trazodone was the third and final med to be tried toward the end of the first year, as the other meds ... citilopram caused violence and nausea, while the prozac did not appear to have an effect(this patient was acutely unwell). My absolute best advice to you, knowing the latest studies/reviews, and what is now proving remarkably effective, is to return to your Doctor armed with the following ...

Where other medications have failed in cases such as yours, and taking into account the varied effects of any med on each individual patient, the following does offer hope. The patient I mentioned in the above text, is now taking prozac and an anti-inflammatory. It's certainly trial and error with any drug, but in your situation, to trial prozac with ibuprofin or aspirin, for example has seen major breakthroughs in treatment for cases such as yours. This is new and groundbreaking. It has the potential to double the effect of any previously available treatments, and is seriously huge news in the psychiatry world. It is working in the case of the above patient. Shall provide you with a link to share with your Doc ...

Tuesday 29 October 2019

Common painkillers such as aspirin and ibuprofen could help curb depression, a study has claimed.

The research found anti-inflammatory agents could restrict major symptoms of depression such as low mood. Fish oils and even statins – the cholesterol-lowering pills that are the most widely prescribed drugs in the country – may also have the same effect, experts say.

Staff at the University of Science and Technology in Wuhan, China, reviewed 26 studies for their research in the Journal of Neurology, Neurosurgery and Psychiatry.

The anti-inflammatories included in the studies were non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and aspirin, omega 3 fatty acids often found in fish oils, cytokine inhibitors, statins and steroids.

Antibiotics, a drug used to treat sleep disorders (modafinil) and N-acetyl cysteine, which is used to loosen excess phlegm in people with cystic fibrosis and chronic obstructive pulmonary disorder (COPD), were also tested.

These medicines and agents were 52 per cent more effective than placebo at reducing overall symptoms of depression and were 79 per cent more effective in eliminating symptoms than placebo, the results suggest.

The most effective drugs were found to be NSAIDs, omega 3 fatty acids, statins and minocyclines.

The effect was greater if these were added to antidepressants.

However, there was no clear link with improved quality of life, although this may have been due to the small number of studies that examined this, the researchers said.

They concluded: “The results of this systematic review suggest that anti-inflammatory agents play an anti-depressant role in patients with major depressive disorder and are reasonably safe.”

Around one in six people in the UK report experiencing a common mental health problem such as anxiety and depression in any given week, according to the charity Mind.

Professor Ed Bullmore, head of the department of psychiatry at the University of Cambridge, welcomed the study.

But he said: “This should encourage further consideration of ways in which we could use a range of anti-inflammatory interventions to help people with depression, perhaps especially people who are already taking a conventional anti-depressant drug with limited benefit.

“However, as the authors conclude, further trials will be needed to support licensing and medical prescription of these and other anti-inflammatory agents for depression.”

David Curtis, honorary professor at University College London, said he was not convinced by the findings.

He said: “It is quite misleading to describe the use of anti-inflammatory agents as safe.”

Source:
https://www.scotsman.com/health/aspirin-and-ibuprofen-could-be-used-to-treat-depression-scientists-1-5034747

PS Thanks so much to MG ... you did good .

PSS JSBach, your best course of action in assisting with your current level of shutdowns, is to remove yourself from the source of your anxiety and immerse yourself in that which takes your mind to a place of calm. eg immersed in music, movies, literature. Some find that removal to nature(a farm environment, a retreat, a safe haven, has made all the difference, though not without the combination of therpeutics and drug/s. Allow yourself the time your body requires to heal from the extremes it is currently under. To not allow yourself this time, and it may well take a good solid year or so, is to deny your body absolutely what it needs. You are risking possible complications on top of what you're currently enduring. eg catatonia. I know of patients who have experienced this and have had the benefit of hearing of their progress through updates. There is a light at the end of the tunnel. You will see it, given the right care and treatment. Give yourself time to recover from this state, however long you need to have your equilibrium restored, and gain control of your body, so you are on top of things, master again, so to speak. Behind you 100%.xx

Shutdowns occur because of stress. When your body absorbs too much stress, it can throw your body into a state of distress. Aspies experience significantly more stress than the average NT. It should almost be our middle name. It sounds like your body is now in a state of trauma. The following are some of the signs of trauma.

* Deer in the headlight frozen expression
* Paleness and racing heartbeat
* Terrified speechless
* Disruptive behavior
* Anger, irritability, mood swings, edginess
* Hyperactive
* Poor concentration
* Demonstrating poor impulse control
* Lethargic, lack of energy
* Depressed
* Shock, denial, or disbelief
* Confusion, feeling out of control
* Anxiety and fear
* Night terrors
* Guilt, shame and self-blame
* Withdrawing from others
* Feeling sad and hopeless
* Feeling disconnected or numb, spacey
* Hyper-focus on mortality or death
* Loss of appetite or overeating
* Obsessive-compulsive behavior
* Avoidance behavior

A panic attack is a sudden episode of intense fear that triggers severe physical reactions when there is no real danger or apparent cause. Panic attacks can be very frightening. When panic attacks occur, you might think you're losing control, having a heart attack or even dying.

Many people have just one or two panic attacks in their lifetimes, and the problem goes away, perhaps when a stressful situation ends. But if they have recurrent, unexpected panic attacks and spent long periods in constant fear of another attack; it can develop into a condition called panic disorder.

When a person is in a traumatized state, they physically lose their ability to talk. One of the things that Bessel van der Kolk showed when he first started to do trauma research with functional MRIs is that when people are in the trauma state, they actually shut down the frontal parts of their brain and particularly the area on the left cortex called Broca's area, which is responsible for speech. When the person is in the traumatic state, those brain regions are literally shut down; they're taken offline. Some Aspies report that during a meltdown, they have difficulty processing speech. It is like hearing white noise. Others indicate they lose their ability to think in words. [When the brain collapses down into the core brain, it is becoming a preverbal brain like that of an infant that hasn’t learned to speak.] Rather their brains revert back to thinking in terms of pictures and video clips and when they try and communicate, their words come out as gibberish. Others indicate they lose their ability to process all sensory inputs. Sometimes during a panic attack, the whole body goes limp and the person will collapse on the floor.

So firstly I will recommend that you focus your attention of resolving stress and trauma rather then focus on Asperger's/Autism. It will be more productive.

One book that will shed some light on the subject is "In an Unspoken Voice" by Peter A. Levine.

I am not a big fan of using prescription medicine to treat this condition. It may help in the short term but long term produces other problems down the road.

Some of the methods for controlling a panic attack are: deep breathing techniques, the vagal maneuver, avoiding triggers, retreat and restore, systematic desensitizing exposure therapy.

Uhmm. When I get partial or full shutdowns, I know that I want to avoid speaking. It takes effort to speak just to tell those around me that I am shutting down and the effort to speak to tell them pushes me a little deeper into shutting down.
The worst case scinario (And I have had this often with family members and others) is where people ten keep talking to you asking you tjings and expecting replies, or making statememts which really wind you up and there is no way you can reply. For example, as I can go into a partial shutdown where my body goes limp and I end up on the floor when I get some unanounced thing given to me to do like "Help me carry this, and I want your help for the next few hours" scinario... And I start helping but the unanounced changing of my previous plans for the day starts me shutting down so my ability while I am carrying something heavy as help has been asked starts to diminish... And then I am on the floor in limp mode and my brother says "You always do this to try to get out of helping" ..... and I can't reply... When I do reply it makes me go straight into a deeper shut down. It is not fair!

Similar things I have with my mother when I start to go into a partial shutdown and need time out... And then she asks me how I feel and what is happening and says things like "If you ignore it, it will go away. That's what I do!" .... And the more she tries to ask me things the deeper I go into a shutdown because
1. I am trying to use my brain to think to reply and
2. I am having to talk when I am trying to cope with the partial shutdown.
It is when I am partly shut down and need time out and can't due to circumstances is where I end up shutting down or battling with trying not to shut down and it is horrible because I HATE shutting down. Partial shutdowns I am so used to I just deal with them by trying to use my remaining strength before my body gets too limp in reaching a place where I can recover. But full shut downs I am in an internal panic when I start to lose rhings like my eyesight and by that time I can't think at all to know if I have lost my hearing as because my hearing goes because my mind shuts down.
What is totally wierd is even in this state, I am still concious of my surroundings? It is wierd. It is not the same as being under general anisthetic where I knew nothing of the event when one wakes up. A shutdown is not like that for me because I am aware of everything around me even if I can't see or hear. Usually I can hear but not make much sense of speech, and this can stick with me for the first couple of minutes while I come out of a shutdown or even a deeper partial shutdown and I will say anything to avoid the need to talk to me so I will either get annoyed and say "Go away" or agree with whatever the other person is saying as quick as I can so I can get them to stop talking and I can recover... And this has got me in trouble so many times because I don't know what the person has said which I have agreed to... It usually starts by needing to ask the other person to repeat something... As my mind can't always take in spoken language when coming out of a partial or full shutdown, and if someone said "Do you understand what I have said" I will say "Yes" because I am trying to make every effort to recover when I have not actually taken in a word, or I have heard it in a distorted form.

[ I hope what I write makes sense to someone. I write to record my thoughts and try to add to the conversation. ]

No that's understandable, I got upset when I was first denied Social Security benefits when I got a paper that said "You're disabled but not enough" Luckily I got a lawyer and she helped me get said benefits. Is there someone like that that could help you?

In the US, it generally takes 3 tries and a lawyer to get benefits. But I see you are in Europe, so that may not apply.

You need to find some way to reduce the stress enough to let your body heal. Lots of sleep. Learn how to calm your mind, be it yoga, meditation, listening to music, deep breathing, recreational reading, cloud watching. It doesn't have to be done "right," just do it. As others have said, this may take a year. Which is depressing in itself, I know. It can't be hurried. Deep breath.

Let people help you. Accept the help they give. You are worth it. Be grateful.

Keep posting.

Edited to remove double post