This might sound counter-intuitive but - tell your therapist exactly this.

That you don’t feel heard (ideally, why that is), how you feel about her stance on medication, that you’re tired of therapy and don’t know how to benefit of it right now (maybe coupled with what beneficial would look like to you) and whatever else is in your head in regards to this session.

This may seem confrontational, but it really isn’t (or doesn’t have to be). It is providing crucial information to a professional about where your head is at in regards to the therapeutic process the both of you (ostensibly) want to start together. It will help her understand where you’re coming from and maybe her reaction will help you get a better feel for if you are indeed a good fit, or not.

I wish you good luck!

Hey, I’ve read your words, and I feel for you.

It seems like you’re caught in an impossible situation - having to work to keep insurance, and not being able to reduce workload without jeopardizing that, worsening the burnout either way. I’m sorry it’s so hard right now.

I would share my own burnout and recovery experience with you to maybe help, but the “getting better” I was able to achieve so far is entirely due to a looong paid medical leave (about 1 year), a 6-week low-intensity in-patient program and the space for transformation that gave me, and I don’t think I could’ve done it this way while continuing to work or support a family. I don’t say that to put salt in your wound, I just want to express that getting better is basically like getting another job - it requires ressources and time and energy. If you absolutely cannot take a break, then please be gentle with yourself if it takes you a lot longer than this to get better. Also, for full disclosure, while I’m now back to normal, my “normal” actually entails being chronically low-level depressed and not being able to consistently function in many ways considered normal for an adult (hence my being on this sub), so it would feel a bit phony to pretend to have the answer.

However, I have one recommendation that might be helpful. I’m not sure if you have the capacity for it, but I really benefitted from the book “Burnout” by Emily and Amelia Nagoski ([https://www.burnoutbook.net/](their website)). It’s not a cure-all and not ADHD-specific, but it is a great guide to explain how stress works and how to really cope with it, especially on a physical level. It’s great for perspective and concrete exercises, and a pretty good read.

I sincerely wish you some peace and room to breathe, somehow!

I have received the result of my ADHD diagnostics, and did not receive the diagnosis for various reasons. Those reasons are valid when viewed through the lense of a diagnostician and I understand why the decision is being made that way. But I still do have many of the symptoms and problems in every day life, which fit the bill (also according to the diagnostics, but that’s not enough), and the alternative explanation they offered is basically ineffable due to lack of research, and in practice this just means that I will not have access to med treatment, even though they might still be helpful. In truth, I think I’m mostly disappointed that I cannot benefit from the well-established treatment protocol for ADHD, and don’t know how hopeful I can now be to get a handle on my life at any point in the future.

I don’t stand alone in this, my therapist is still going to give me a cognitive-behavioural training designed to help with executive function deficits. And I have already learned, that I’m allowed to stay 'round here even without the label. :)

But together with some other stressful stuff happening, I’m not doing so well, I think.

Ja, ergibt definitiv Sinn, wenn es zeitlich passt. Es ist auch absolut üblich, bei mehreren Therapeuten in die Sprechstunde zu gehen. Es gibt ja nicht nur verschiedene Therapeutenpersönlichkeiten, sondern auch verschiedene Therapieverfahren (z.B. kognitive Verhaltenstherapie und Tiefenpsychologische Psychotherapie, unter anderen), die mehr oder weniger gut zur eigenen Persönlichkeit und zum eigenen Problem passen.

Gerade in der Sprechstunde geht es ja erstmal hauptsächlich darum, dass du dich vorstellst und schilderst, worum es geht, und der Therapeut sich und sein Verfahren vorstellt, und ihr guckt, ob das zusammenpassen könnte. Alles noch relativ unverbindlich. Und auch danach würde es (wenn ein Therapieplatz frei ist) erstmal mit den sog. “probatorischen Stunden” weiter gehen, wo nochmal genauer geschaut wird, was das Problem ist, wie es sich äußert, sich deine Biographie angeguckt wird - alles Informationen, mit denen der Therapeut dann die weitere Therapie planen kann. Parallel wird da auch die Beziehung zum Therapeuten weiter aufgebaut und gefestigt, man lernt sich halt besser kennen. Und erst danach kommt dann die “eigentliche” Psychotherapie, wo’s dann an die Arbeit geht, und für die der Antrag an die Krankenkasse gestellt werden muss.

Einziges Caveat: wenn es für dich sehr belastend sein sollte, deine Problemlage anderen Menschen zu schildern, oder auch generell mit neuen Menschen zu sprechen, kann es natürlich passieren, dass du nach dem ersten Termin eigentlich schon durch bist, und dir der zweite kurze Zeit später zu viel werden könnte. Das weißt du aber am besten selber!

Ich sekundiere, dass du hinfahren solltest - Terminservicestelle funktioniert in der Regel, auch ohne Bestätigung von der Praxis. Die Termine, die dort vergeben werden, werden meines Wissens nach von den Praxen zur Servicestelle als frei hingemeldet, und die kriegen dann wieder bescheid, wenn der Termin vergeben wurde, um sich drauf einzustellen.

Ich versteh aber auch, dass du dich rückversichern möchtest, vor allem bei dem Fahraufwand. Es ist aber leider tatsächlich so, dass wegen der extremen Überlastung der Therapie-Praxen (habe ich dir bei deiner letzten Frage ja schon beschrieben) der Service für noch nicht aufgenommene Klienten meistens absolut minimal ist - d.h. keine Rückrufe, keine Mail-Bestätigungen, kaum Telefonsprechzeiten, AB nur für schon aufgenommene Klienten. Das ist weder schön noch emotional förderlich für die Therapie-Interessenten, aber eine Psychotherapeutin, die ich privat kenne, hat mir bestätigt, dass es ihr zwar sehr unangenehm ist, das so zu handhaben, aber einfach absolut nicht leistbar ist, das neben der Vollauslastung auch noch anzubieten, weil sie dann 12 Stunden Tage hätte, von denen 4 unbezahlt wären. Und Sprechstundenhilfen, die das übernehmen gibt es auch eher selten in der Psychotherapie, selbst bei psychotherapeutisch tätigen Ärzten. Dafür ist das Feld auch einfach i.d.R. nicht lukrativ genug, außer man hat z.B. über Gutachtenstellung noch einen Nebenverdienst oder eine gut laufende Gemeinschaftspraxis.

Will sagen: dass du da keinen erreichst, ist nicht persönlich, und hat auch nichts mit Desinteresse aufseiten der Ärztin zu tun. Das sind in aller Regel Finanz- und Sachzwänge und Überlastung. Das Terminvergabesystem funktioniert aber trotzdem gut genug, um zum Termin zu fahren.

Noch positiver Erfahrungsbericht für die Hoffnung: Ich habe letztes Jahr nach 9 Monaten intensiver Therapieplatzsuche (war krankgeschrieben, hatte also auch nicht viel anderes zu tun) über den Terminservice tatsächlich nicht nur ein Erstgespräch, sondern auch einen freien Platz, der auch noch gut passte, gefunden. War Glück und Timing, aber es kann funktionieren.

Viel Erfolg! :)

Thanks :)

Which text are you referring to? Sounds interesting!

Yes, she is! I personally am just so glad I could help at all and not have her watch go through that ordeal by herself… and to have managed to make a significant difference for her, she says. That doesn’t always happen when trying to help and support, and I am so happy that this time, it did :)

I feel fantastic right now - in the last week, I have hyper focussed for several days to help a dear friend prepare for a court date (the kind of task that has “important/interesting to me” and “urgent” written all over it), and due to our preparation, it went really well for her. And I am happy, relieved and quite proud of us - while also feeling completely trashed from overtaxing my physical ressources in the process.

Absolutely worth it, though. I will, however, now take a break of several days.

There’s a difference between signalling the brain to release its own dopamine and taking external dopamine. (Important note: All of this is a simplification, I am not an expert!)

The first could be done with drugs (legal and illegal) or other dopamine-stimulating activities with instant rewards, and it absolutely has the ability to change our reasoning (like “Oh yeah, I’ll definitely feel better if I sit motionlessly for hours scrolling memes I don’t even find that funny, and should not, as logic and knowledge dictates, maybe go outside and move my body a little, because that won’t feel as good (doesn’t release as much dopamine)”). So here, the answer is yes, totally. Which is why for example ADHD medication tries to effect an easier release of dopamine to make it easier on the brain-carrier to make different choices, away from instant reward towards delayed gratification.

For the second thing - dopamine’s precursor, L-Dopa, is the straightest way to actually add more dopamine to the brain (since dopamine itself can not pass the blood-brain-barrier, but L-dopa can and is then synthesized into dopamine), which is done in Parkinson’s patients and helps them tremendously. Interestingly however, if you overdose it, you can fall into a drug-induced psychosis, a state in which one could argue that logic and reasoning are indeed affected, so that’s another yes, but not in the way you mean, I think.

In conclusion, brain neurotransmitter chemistry is pretty complicated, but interesting, and the answer to the question if changing something about it will lead to different ways of thinking is very often yes, which is why medicine is doing it :)

I wanted to let you know that your story resonated deeply with me. We had a similar family dynamic in parts (esp. the teaming up by apparent neurotypes), only nobody is officially diagnosed (I’m still waiting for results), which made it even harder to make sense of for a long time. So I feel for you!

During my university years especially, I also struggled heavily with keeping up with household stuff, which made me quite the unpopular flat mate… it’s a huge source of shame for me, and still affects me to this day (though I’d like to believe I’ve gotten better).

Thank you for sharing, even if it is uncomfortable, it made me feel less alone with these experiences - so please don’t feel like you have to apologize :)

4-5 / 0-1 / 4-5 / 0-1, repeated for at least 1 minute, better 5 minutes or more. (not too deep or light-headedness can happen)

This is resonance frequency breathing (at round about 0,1 Hz) which maximizes heart rate variability and activates the baroreflex (blood pressure). It’s usually used with a HRV biofeedback device to find the best individual breathing frequency, but it’s not strictly necessary. Just find the speed around these marks that feels good (without feeling like you’re out of breath or getting dizzy). Breath into your belly.

There’s tons of studies for its effects, but mostly it activates your vagal control, and thus tones down anxiety, can help with depression and PTSD symptoms when done regularly, and also helps with high blood pressure, can make recovery after heart surgery easier, is used in professional sports, may help with IBS etc. Look for papers on “HRV biofeedback effects”, if you’re interested.

The most immediate effect I personally have is feeling both more relaxed and more alert, similar to after meditation.

I’ve been using ChatGPT to find inspiration for greeting cards (for birthday, wedding etc.) for people I don’t know that well.

In christianity, there are recognized forms of prayer that are literally the same technique as focus-based meditation - only that the focus is not your breath, or a candle, but your inner connection to god as you experience it. This is called contemplation and has a centuries-long history in christian mysticism.

If you practice it, I confidently say you would gain quite the same benefits as you would with focus-based meditation.

Also I have tried both, and don’t feel much of a difference in terms of “what I’m doing with my brain”.

I’m sure you’re talking about people going " Please god, give me the new car I’ve wanted for so long" rather than prayer as a spiritual practice to gain connection to the the “first reality before any thought arises”, which is how modern christian mystics define god, so this likely isn’t relevant to you and your beliefs and also isn’t meant to be a rebuttal of your overall stance.

I just wanted to let you know that in this instance you are, indeed, factually wrong.

I was in a very similar position during 2022. It’s a perfect burnout recipe, chronic stressors everywhere and no power to change them. I could feel it building, but was still able to work and the personal stakes were high, so I wanted to make it to the end (which would have been in early 2023). I didn’t. I had a break-down in fall, I couldn’t do anything anymore (no focus, no energy, really bad memory, lots of mistakes at work). I took sick leave and have been in recovery since, and still don’t feel really alright. I have met people who went further than me and have done themselves really bad, and even physical damage doing so - psyche and body feel different, but they are parts of the same organism, and to overtax one is to overtax the other.

In no way was it worth it. I would have chosen differently if I had known what the later stages of burnout felt like.

I really mean it - if it’s in any way feasible and you’ve exhausted other pathways to change inside your role, quit before your body does it for you.

When you feel the burnout building up, you really should not try to stick it out “just until this project is done and I can get some rest”…

Musste bei deinem Post sofort an diese beiden Nudelaufläufe denken, die keinen Käse drüber brauchen und wo man die kleinen Mengen Milch- oder Milchersatzprodukte ziemlich gut ersetzen kann, ohne den Geschmack völlig zu verändern - und die ich persönlich echt richtig lecker finde!

https://www.eat-this.org/pastaauflauf-mit-pilzen-artischocken/

https://www.lecker.de/wilde-nudel-auflauf-74314.html

Ich glaube, ihr findet Möglichkeiten :)

I think it’s not half as interesting as you think it might be…

I had a huge trash bag in my home office from a long ago deep clean of my flat, filled with all kinds of stuff. It was there so long it was basically furniture.

The sticking point was that because of local laws, I had to sort out the recyclable trash and dump it in the special dumpsters before getting rid of the rest. (Also, I knew that before gathering the trash all together like this, but it seemed easier at the time…)

Last week, due to external pressures, I finally managed to lug the bag to the dumpsters and do it. It only took 15 minutes, but it sucked exactly as much as I thought it would - just putting my arms in there searching for paper and recyclable plastics, not even knowing what was in there anymore… thankfully it didn’t smell, but when I accidentally grabbed a very old, unsuffiently packaged positive covid home testing kit, I called it a day, dumped the rest (neighbours be damned) and went home to scrub my hands clean…

0/10, would procrastinate again. :D

This happens to me with surprising regularity… HOWEVER - I recently managed to do a chore after 9 months of procrastination, and while it did only take 15 minutes, those minutes sucked so bad that, for a change, I felt really justified in putting it off as long as I did. So it can go either way, I guess!