Meltdowns vs. Anxiety Attacks...

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Sigh, I'm starting to get severe meltdowns/anxiety attacks again and why I put the slash is because of disagreement, lol.

I started having extreme emotional episodes again a couple weeks ago, which I identified as meltdowns caused by triggers... But the doctor said they were anxiety attacks caused by mania... Anyway anxiety meds were added... Which provided only temporary relief however...

Now I'm stuck in a situation where I'm so emotionally triggered idk what to do, also the doc is thinking of adding something like Borderline to my diagnosis... Again...

I have appointments soon to address these issues, but in the middle of these episodes I can't stand the emotional pain, triggered now by very simple things like worrying about if I should work, etc..

Meltdowns? Anxiety Attacks??? Sigh...

For me a meltdown is more often associated with the frustration of attempting to accomplish a series of tasks when I drop something or otherwise have a plan unexpectedly interrupted. The unexpected suddenness of the interruption contributes to the meltdown. In my mind is an image of a series of dams on a river where one failure causes a cascade of failures is rapid succession. However, I find that I am able to regain balance in just a few minutes after the cascade. It is as if the meltdown has released accumulated energy.

I would view an anxiety attack as the increasing awareness of uncertainties. When this happens quickly, the mind is unable to resolve a situation in terms of assurance or even contingencies. This is sometimes defined in terms of fear, but a more accurate approximation might be seen in a situation where suddenly gravity no longer worked. The lack of certainty of what to expect can produce paralyzing apprehension.

Either of these two situations might be managed by slowing down. If I take a more measured approach to task completion, an unexpected sudden interruption has less accumulated emotional energy to work with. If I know I am going to visit somewhere unfamiliar, I can research and get as much information as I can which can help provide a little more certainty.

Sorry to hear it, that sounds horrible.

The main problem I'm hearing is a lack of consideration for how your sensitivities are triggered and a lack of emphasis on reducing those stressors, getting accommodations in place and building sources of resiliency against them.

If that seems to fit, you can try pointing this out explicitly, and put forward the idea that this is the kind of help you really need.

Unfortunately, this sounds like this clinician might not be sufficiently in touch with the autistic experience.

I'm curious, was this the clinician who finally got you your diagnosis? Does their practice specialize in autism?

My episodes are being triggered by things that remind me of past things that brought trauma btw

Has anybody diagnosed you with Post Traumatic Stress Disorder? What you just said is a classic example of it.

"Mania" - now that's an interesting word. Before I went on Sertraline I used to have these outbursts and I don't know if they were meltdowns or something else. They weren't related to sensory issues, they were usually triggered by the wrong thing being said to me and then not knowing what else to do other than exploding. These outbursts typically involved shouting, swearing, crying, arguing, hitting myself and slamming doors. Sometimes I was really laid-back, then the next minute it didn't take much to trigger an outburst. No stimming involved.
Could this have been mania of some sort?

Sounds like PTSD to me

It sounds like flooding.

https://giusisilvestri.com/blog/emotion ... o-about-it

I'm glad it helped.

I flood because of CPTSD, anxiety, and alexithymia. It seems to happen about every six weeks. There are smaller problems during that time, but around six weeks I tend to hit my emotional limit and flip out.

My trauma psychologist helped me to track it. At first she thought it was hormonal, but over time we realised it's flooding.

That means:

Because of my alexithymia I can't manage two emotions at the same time.
It's really bad if one of the emotions is a trauma trigger emotion for me (guilt, shame, helplessness).
Even if I add on a positive emotion (happy), it makes me short-circuit because I can't process two feelings at once.

I recommend you print out the article for your therapist.

My trauma therapist suggested that I keep a journal so I can identify my feelings when they're building up.
It's turned into me writing a book since Christmas.

It's helped a lot. I've only flooded maybe two or three times since then.

Ironically some "helpful" (not) medications cause this in me, as well as hormones (monthly). Put the two together, or add in a transition or stress and I'm near explosive. I am very energetic in general but don't have manic episodes "naturally". Once an anti-depressant medication made me manic (I kept climbing onto things). There was another medication that made it so I couldn't sit down (constant pacing and movement). The list goes on. My ASD and sensory issues are so mixed up with my anxiety and PTSD, heck if I can tell where one begins and one ends.

I also experience the meltdown/anxiety attack/flood as I-can't-stand-it-anymore like a physical pain (and sometimes wish someone would just knock my head off so it would stop); however I do not have (or notice) shortness of breath or feel like I am going to die or racing heartbeat are all those other things used to describe anxiety and panic attacks. I just can't take it anymore and sometimes I throw myself under the sheets, especially if it's triggered a migraine. Might be better for me to sway or rock or something, but I'm still new to my ASD diagnosis and was long ago "taught" to "control" myself (freeze, shutdown) rather than adjust more humanely.

It took me quite a while to identify the physical warning signs with my OT, because I have low interoceptive awareness. Now I can recognise that my arms feel heavy and tingly like lead, and there's an adrenaline surge which makes my breathing much more shallow. I can't feel the change in my pulse but I've checked it with my BP monitor and it's always elevated. My thoughts start racing and cycling over and over on the same topic.

I normally experience this thought pattern (it took me a year to recognise it):

- This isn't a flood
- I'm fine
- I'm not flooding
- I'm totally logical this time
- This is justified
- All I need to do is explain myself
- I'm not flooding
- This is different!
- This is reasonable
- My emotions are ___ and ___ but they're justified
- I'm not flooding
- I'm not flooding
- This is fine
- I'm under control
- This is reasonable
- The other person is wrong
- I'm not flooding
- I just need to write / say / do this _________________

* starts making frantic notes to justify self *

- I'm sure I'm not flooding
- This is fine
- Maybe I should consider it a flood?
- No, I'm not flooding
- Hyperventilates and writes more notes
- I'm sure I'm fine
- This isn't a flood

etc

Finally I have an AHA! moment, and convince myself to chill the f out.

It's a lot farther along than I was a year ago, when I'd react instantly before processing.

Now at least I see this process happening, usually about 1-24 hours after it starts.

I consider floods to be emotional, and meltdowns to be sensory.

Anxiety attacks are usually a specific situation which is literally making me anxious (as opposed to other emotions like fear, guilt, shame, helplessness, or double-whammy emotions which I can't process because of alexithymia).

My therapist couldnt meet with me, all I got was a talk with my caseworker for a short period of time...

I'm the meantime I have a severe migraine now from this, I'm still getting easily upset, etc...

Now I have another emergency med appointment tomorrow... But in the meantime it's just pure cycling... Sometimes I'm just in a hypomanic/overly happy mood for a few days, then I crash like this, get "flooded" or whatever's happening to me very very easily...