Looking for Hope: AuDHD, Burnout, Anxiety, Starting Strattera after being off stimulants

Hello Everyone,

This is my first post ever on Reddit, so I am hoping that this turns out OK.

I wanted to share my story as I am hoping to hear from other people who have made it through what I am experiencing. I am looking for inspiration and experiences that will give me some hope to hold on to. Any advice, kind words, or personal examples of success you can provide are much appreciated.

About me: I am a 38-year-old male (gay); married. I consider myself to be relatively healthy, exercise daily, try to eat nutritious food for every meal, and maintain a regular sleep schedule. I live in a small town (less than 50,000 people). I am considered a “high-achiever”, self-driven and  admittedly a perfectionist. I have a strong internal critic, which is currently beating me to a pulp. Most people would describe me as kind and funny. Things that normally give me pleasure outside of work are: travelling, fitness, gardening, trying new restaurants and foods, researching interesting topics, and deep conversations with close friends.

It was confirmed in the summer of 2024 by a psychologist that I have ADHD and “broad autism phenotype” (essentially I am autistic, but the traits do not rise to the level of a disorder). I am definitely an introvert and I agree with the psychologist’s assessment that I am part of the “highly emotional people” group. Myers-Briggs classifies me as an INTJ (Introverted, Intuitive, Thinking, and Judging). In Attachment Theory, I am classified as having an anxious attachment type.

PAST TO PRESENT: MENTAL HEALTH HISTORICAL NARRATIVE

Past -  When I was in my mid-20’s, I dropped out of my PhD program due to a severe depression and anxiety, following a bad break-up, coming out and trying to navigate life on my own away from home. I moved back home, and went through what felt like an absolute nightmare; it took me 3-4 months to start working again. I battled severe depression and anxiety, not knowing at the time that I had ADHD. The key to my recovery was 50 mg of Pristiq per day, a lot of Ativan, walking daily, therapy, eating healthy, a lot of crying, and a lot of support from family. I did not take any ADHD meds at this time (as I would not be diagnosed until over ten years later).

During my life, I never had any single traumatic events that I can recall. However, I am sure that I experienced “little-t” traumas from being closeted until I was 25, and from not knowing that I was adhd/autistic trying to operate in a world made for people without adhd (I believe the pain caused from bullying I experienced as a child related a lot to my emotional dysregulation and different social skills). 

From mid-20’s until summer 2024: After I made it through the depression in my mid-20s, I managed to fully “re-enter” the world. I got a job, and moved up the corporate ladder quite quickly. I finished my PhD and I got married to the absolutely sweetest and kindest man I know. We bought a house, a dog… the whole bit. I experienced real external markers of success: awards, recognition, etc. In retrospect, I believe this all fuelled my need for external validation. During this period, I had slight “bouts” of burnout and depression largely emanating from something work-related (and/or me pushing myself too much). However, I never was so burned out or anxious that I could not work. I always made my way out of these bouts by changing things up such as new jobs or promotions. However, I think during this period, my inner critique of “you are not good enough”, “you must work harder”, etc. slowly started to take deep hold, as I was never satisfied that I was doing enough. I continued in therapy on and off during this period as my anxiety would peak.

Summer 2024: In the summer of 2024, I was starting to feel a bit more of an intense burnout, related to professional course I was taking. Despite all my studying and work, I was simply not progressing (which was definitely hard for me to compute, as I often excel at most things I do). I began to suspect I had a learning disability. After seeing a psychologist and completing 6 hours of a psycho-social-educational assessment, I found out that I had ADHD / autism.

Once I titrated up to the therapeutic dose of Vyvanse (50mg), it felt like my life was completely different. My anxiety left me completely, to the point that I could not believe it. I felt like I could finally regulate my emptions, and so much pain and frustration from the past made sense: My brain was always just looking for stimulation; lack of executive functioning made managing emotions difficult; etc.

I passed my course and returned to work with like this new sense of who I was; it felt incredible.

Early 2025 to Spring 2025: I started a new job, one which was a huge promotion in terms of title and pay at another organization, where I thought I would have the opportunity to develop teams and make a real positive change in people’s lives. As mentioned, my boss ended up being incredibly horrendous and the workplace was toxic and never felt safe (I will not provide all details for the sake of brevity, but just imagine a completely chaotic, emotionally-raged supervisor destabalizing you every 2-3 hours during a work day). My system collapsed in the spring, and I went on sick leave.

Spring 2025 - Burnout: Initially when I went on sick leave, I thought it was only going to take me 1-2 months at nost to feel better. The burnout I experienced (and am still making my way through) has been unbelievably intense: Initially I was having night tremors, night sweats, sleep walking, vomiting in the middle of the night, panic attacks, unable to concentrate on anything, etc. However, once the burnout symptoms started to lift, it was replaced with constant and intense anxiety and depression.

Luckily, this has not happened in the past 1.5 months, so I suppose this shows some level of improvement. However, I still struggle daily with a high baseline anxiety, and am constantly getting caught in mental “loops” in my head catastrophizing, and struggling to maintain a routine and manage predictability/boredom (thinking that this is an ADHD thing). My self-confidence is compeltely shattered, and I struggle to know who I even am sometimes. I feel like I could slip back into total emotional and functional collapse at any moment. Boredom and lack of desire to do anything is really a curse for me right now. Nothing feels “good enough” to do, like there is no rewward for me (evern though I know that certain activities would normally make me feel rewarded). The rumination and anxiety is so bad at times that I literally am paralyzed, unable to make even small decisions. I can ruminate on something for 2 hours, even after trying to distract (with nornmally only ativan or A LOT of talking to my parents or husband causing the rumination to stop). I often slip into hopelessness, which then spikes my anxiety even further.

I have 2 months more sick leave left to find a new job in a different organization. I have received some good feedback from hiring managers which appears hopeful. They are both for much lower-paying jobs in junior roles in my field of interest (types of jobs I did ten years ago). While this hurts the ego a bit, I am trying to ignore that and think that these types of jobs are for my health. However, almost daily I will find myself spiraling, anxiety high, and “locked into” my thoughts, and catastrophizing that I will never be able to work, given my current mental health state. Every day is a struggle. I have had some good days, but for the past 2 weeks or so, my brain feels like it is starting to collapse underneath all of the constant rumination and catastrophizing.

Treatment: I am seeing a therapist and have a family doctor as well as a pharmacist who provides hour-long consultations to assist with selecting medications. My treatment plan also includes as much rest as possible (I am not good at this, as everytime I try to nap, watch TV, etc. I just want to panic and run), walks in nature, being outside as much as possible, avoiding high stimulating events, etc.

Medications

Vyvanse (discontinued): During my first 2 weeks of burnout, I continued to take 50mg of Vyvnase. However, I quickly learned that the crash from the Vyvanse was disastrous (causing me to go to the hospital at one point for a visit with the ER psychiatrist). I never experienced an intense crash with Vyvanse, prior to be burning out. When I came off of Vyvnase, I felt a bit better knowing that I would not have to deal with the crash and felt like I could fully “feel” and realize the situation I was in. For a few weeks I was OK off of Vyvanse, keeping myself busy fixing up the house, small projects, gardening, etc. I briefly tried going on a low dose of Vyvanse (20 mg), and also Concerta, but the crash again was too much. My pharmacist/doctor said that it “may” be that the stimulant is too much on my nervous system at the moment.

Strattera (first dose today): Following a consultation with the pharmacist at my doctor’s office, she decided to start me on 25mg of Strattera (non-stimulant) for two weeks, and then increase to 40mg. I took my first dose today; I am really hoping that the Strattera helps with my ADHD symptoms (mainly rumination, emotional regulation, and internal satisfaction/reward) which may then reduce my anxiety and reliance on Ativan. I feel like my ADHD symptoms may be keeping me in a “holding pattern” a bit: overthinking, catastrophizing, etc. which activates my nervous system. I am bored to tears but the things that normally would give me a sense of reward seem pointless. I look forward to having the structure of a job in my day, but I am terrified it will be too much for me to handle.  I am hopefule, but EXTREMELY apprehensive whether Strattera will work; I hope it does - I really need hope. However, I am worried that I am just “kidding myself” regarding the positive effect Strattera may have. I know how good I feel when I take a stimulant. I am not expecting Strattera to do that; rather, I am hoping that even just a slight reduction in my ADHD symptoms would reduce my anxiety enough to allow me to think beyond the very present moment, cry when I need to, talk to myself more positively, and heal (and therefore reduce the amount of ativan I need; the fear I have of this drug almost reduces the hope it gives me sometimes).

Ativan: I know all of the risks of dependency, etc. associated with Ativan. However, right now I am using 1mg to 1.5mg per day, as it is the only thing that let’s me access my feelings, gives my nervous system a rest, cry, read books, walk in nature, etc. with a sense that I am healing. It does concern me that I have been using 1mg to 1.5mg per day for over 1.5 months now, but really it is the only thing that is acting as a “bridge” for me, until I find medications and a life structure that works reduced my anxiety. The pharmacist does not have any issue with me using it, given my current situation. When I take Ativan, and have had time to reflect, cry and journal, I start to feel a glimmer of “hope” that I will make it out of this storm

Socializing:

Prior to burnout, while I was an introvert, I did not have any extreme social anxiety/fear about being in big groups, parties, etc. from time-to-time. In fact, at times I would love hosting parties at my house. Now in burnout, I feel so completely and utterly overwhelmed by the thought of large groups and having to maintain conversations with people who do not know or understand what I am going through. It is summer, so the pressure to socialize is high. I also have this nagging critical thought in my head that “you should be socializing more”. My socialization is mainly: phone calls with my best friend, talking with husband and parents, light socialization at the gym every morning, and I try to go out of my way to strike up a conversation when I am grabbing a drink at a café.

One last point - ChatGPT:

In addition to my human therapist, I have been using ChatGPT A LOT to help talk back to anxious thoughts I am having, reminding me of my healing journey, etc. It seems to help, but sometimes I feel like I am relying on it too much.

~TOPICS / QUESTIONS FOR FEEDBACK~

Below are some questions / concerns I have that I was hoping people could chime in on to give me hope (I am already very aware of all the side effects and “what-if” catastrophic scenarios, so I am hoping for stories, ideas or examples from people which can provide me with a bit of hope to hold on to, particularly during the dark or scary times. Examples of how you made it through similar situations would also help).

1. Has anyone been through a similar situation of burnout where they used Strattera to help them get “out of the hole?”

2. Has anyone used Ativan for 3-4 months daily to act as a “bridge” until they were stabilized?

3. Has anyone had success with treating ADHD with Strattera, particularly when unemployed?

4. Has anyone had success with treating ADHD with Strattera when employed?

5. What are people’s experiences with returning to a different job following a burnout (with ADHD / autism)?

6. What are people’s experiences with socializing during burnout? Particularly from an ADHD / Autism perspective? I do want to socialize again someday, but right now it feels like too much (and I beat myself up for missing events, even though they feel overwhelming; I am worried I might regret something I suppose).

7. I find it difficult to develop a routine at this point as nothing is interesting me. I had more of a routine during the first month or so of burnout, but everything just feels like such a struggle now. I try to have “anchors” and a “middle” in my day (e.g., gym in the morning, light task after that, lunch, therapy or walk in the afternoon, then supper with husband, Ativan, watch TV with husband/read, go to bed). Has anyone struggled with routines during burnout recovery but still managed to get through it?

8. A lot of the advice I get from family/friends (and even therapists) has good intentions: The advice identifies the “problems” I have but never really any concrete solutions. For example, “you need to be more compassionate with yourself” (Me: how?; I am reading the books but my brain is constantly all over the place); “your identity is really wrapped up in your work and productivity” (Me: I have known this for a while, how does one separate their identity from a place they spend 40 hours per week, when their brain at the moment can barely decide on whether to have breakfast before or after the gym?); “You need to ‘talk back’ to the anxious/critical voice in your head” (Me: How?  The critical voice is constant, I literally cannot keep up with it, and when I do talk back, the critical voice responds with something even more critical, creating an ongoing loop).

Any hope you can provide in this area is much appreciated.

 Many thanks for taking the time to read my post and offer your examples of hope. Super grateful knowing there are others out there. If you have any questions, please feel free to ask.

 Have a great day.