I have been thinking about making this post for days, but I generally do not post online, and I have not been sure how to structure it. My apologies in advance if this gets excessively wordy.
TL;DR: diagnosed as ADHD, but something about my burnout, dissociation, and other presenting symptoms does not make sense to me, and I want to know if what I am experiencing is relatable to anyone here.
Background
A few years ago, I was diagnosed with ADHD when I really did not think I had it. Being diagnosed and beginning treatment was incredibly helpful for me, and it felt like I finally got some air after an adult life of drowning. The past couple years, however, I have been experiencing what I would ordinarily describe as DP/DR or just general dissociation, but lately I have been beginning to wonder if what I am experiencing is related to undiagnosed autism, as it feels like some things are not adding up if all I have is ADHD. I would love to hear from you whether any of this is relatable.
Some Disclaimers
The goal of this post is not to receive a diagnosis, but to get some clarity as to whether I am even on the right track by hearing from others whether they have similar experiences. I also recognize that autism is a spectrum and not some binary trait. It is precisely for these reasons that I wish to hear from others as to whether any of the below is relatable to those in this community, especially the things that I have not read or heard about in other resources related to AuDHD.
My Experience: The Present
I wake up in the morning and there are already 3-4 things going on in my mind at once. For about 2 months, I woke up with the same 5-10 seconds of a DCI drum corps show section looping in my head, and on top of that is some song I heard a few days prior, and then one or two conversations I had recently that I cannot get out of my mind. I am bilingual having acquired Japanese in adulthood, so there is a constant barrage of memes and media that fills my mind at all times.
I often have thoughts to do things that are productive, creative, or otherwise would likely be good things for me to do, but it feels like those thoughts are drowned out by all the other noise in my brain. What's more, it feels as though the motor of thought is spinning, but whatever cognitive clutch is required to turn thought into action is totally worn out, rendering all manner of thought completely unactionable.
Just about every social engagement feels like a massive burden, despite me recognizing in my head that I ought not to isolate and that I don't even necessarily dislike the people that I am to socialize with. At the same time, being around most other people makes me feel like some alien, and the people around me that are most notably neurotypical are especially difficult for me to understand. A friend or someone from church will try to share some kind of advice with me, and it genuinely feels like they're giving advice that's for some different specification of human being, so much so that it feels impossible to seriously consider anything they're saying to me.
I remember a point in time in which I had more emotions, but now I feel like I am an empty shell of my former self. It may be a strange or incredibly specific example, but in Kingdom Hearts terms, I feel like a Nobody, the shell of a person after the heart has separated from the body. Nobodies do not have hearts, but they do have memories, and therefore continue to act in ways that they remember themselves acting in the past while not actually acting from a real heart. That is how I have felt for about a couple years now.
I am experiencing burnout unlike anything I have experienced before. Everything is incredibly exhausting, especially if it feels like it demands any executive function to accomplish. I have lived on my own in Japan a couple times, and for the most part I think I did well living in a smaller space, but now that I have my own apartment in the US, it feels impossible for me to keep up with all the cleaning, organizing, or whatever else I'm convinced I'm technically supposed to be doing, and it's exhausting even thinking about the fact that I'm not accomplishing any of it.
I do not really know who I am anymore some days. There have been some days lately where I look in the mirror and do not recognize myself. I feel like I used to have some kind of framework for understanding who I am and how I fit in the world around me, but it feels like such a framework no longer exists, or is at least in shambles.
I have a very difficult time transitioning to different environments and keeping up with habits, relationships, etc., and I have been bouncing back and forth between the US and Japan for the past 4-5 years or so. It feels like I constantly and making new connections, which in a sense is thrilling but also incredibly burdensome. I have no idea how to invest in or maintain past relationships while also doing the same with present ones, and I honestly have no basis for knowing which relationships I actually value anymore. I often end up just assigning lower value to more recent relationships and more value to past ones, even if some of those past relationships feel inactive relative to more recent ones.
I think all the time now about others' sense of experience in life. A lot of the time I wonder what causes people to post things online like comments or videos. Are people just really that passionate, and I lack the passion to do such things? Was I like that back when I had more emotions? Are people just really confident? I have no idea. Thinking about it is somehow both fascinating and terrifying.
I am currently prescribed a low dose of Adderall, and I find it very helpful for managing the brain fog/noise. It almost seems to have a backwards effect on me though, where I am normally inattentive ADHD, but taking Adderall makes me feel like I turn into a hyperactive ADHD type. I become significantly more talkative, louder at times, and on good days I can sort of short-term hyperfocus on certain things.
The Past: Childhood and Adolescence
When I meet people diagnosed with autism and/or those who very strongly present as autistic, or when I read/hear about how autism often presents, it reminds me a lot of how I was as a child. I am an identical twin, and my brother and I were incredibly obsessive. Maybe this is more normal for children than I understand, but we would go through seasons of obsessing over Pokémon, then Yu-Gi-Oh!, then Duel Masters, then Sonic the Hedgehog, then Kingdom Hearts, then Legend of Zelda, Megaman, etc. until it all looped back and the cycle would start again. We would also discuss such obsessions at school as though other people knew about them, even though it seemed most people our age had little to no familiarity with most of the things that we were interested in and they certainly were not as obsessed. We were also both incredibly quiet and shy, sometimes to the point of crying if we had to speak to a stranger. It's hard to tell if it was because of a love for order/patterns or if I just felt left out, but my mother reminds me often of a time when I cried because there was no napkin in my school lunchbox.
In adolescence, we were still very quiet, but were considered academically gifted and simply "good kids." I remember not being very interested in what it seemed most kids my age were interested in, except maybe romance, although my idea of what romance ought to be was quite grand and probably seemed delusional to the girls I tried to date at that time. There was always tension in my romantic relationships, and I think much of it came from having ideas of what relationships were meant to be that did not match with reality (this could very well just be said of a neurotypical adolescent, I admit). This was true up until very recently when I started dating my current girlfriend, who makes me feel like I'm a normal person in a world where interactions with other people often make me feel like an alien.
I used to listen to music that I considered beautiful in high school, like Adagio for Strings, Air on a G String, etc., and I could just cry to the music and it was wonderful. I also experienced stronger emotions in relationships, where the highs felt incredibly high and the lows incredibly low. I was like that up until my 4th year of high school, where for seemingly no reason I started losing my emotions and experienced strong cognitive decline. I did not know the terms "dissociation" or "depersonalization/derealization," at the time, but I would experience something I called "graying out," where it felt like my sense of existence got so far separated from my physical body that I would just leave reality momentarily and then come back. Even when I came back though, it was like trying to move a marionette from a few feet away in a body of water.
My then girlfriend suggested I might be depressed, and after starting therapy, I was eventually diagnosed as having high anxiety with some level of depression and thus prescribed Sertraline (Zoloft). From there, my emotions started to return, and with it any sense of morals, beliefs, my long and short-term memory, and a drive to actually accomplish things in my life. I stayed on Sertraline for years, believing it to be necessary for me to function and possess the closest thing to a normal emotional range that I could have.
My brother and I also always had really long '80s hair up until that same period of time, just because we were so obsessed with '80s metal, but then after I started cutting my hair shorter, for some reason I started learning how to tie every kind of necktie knot, and I started wearing dress shirts with vests and ties every single day to school. It wasn't really for attention as much as it brought me some kind of comfort, and whenever I felt anxious or overstimulated in class, I would re-tie my necktie knot over and over again.
Wrapping Up
I can tell this post is a mess. I can feel my train of thought running away from me, and I am sure I did not include everything in here I wanted to include. Thank you for reading to the end.
If anything that I shared seems relatable or similar to your own experiences, I would love to hear about it. Thank you.