u/AgileWoodpecker3273

28m dx'd with ADHD, OCD, PTSD, Depression, and Anxiety (social & panic disorder). Currently on levothyroxine, rabeprazole, prazosin, Tylenol, and Imodium.

So, I have a history of colon cancer and various GI disorders, and my iron (and ferritin) basically runs chronically low (both in the low 40's). Because I'm technically not anemic (hemoglobin of 13-13.5 is common for me), doctors wouldn't give me IV iron. I'm also on a PPI long term, which I gather doesn't help the absorption side of things.

I finally recently convinced a sleep doctor (out of all docs, haha. I have a hematologist/oncologist, a gastro, and a PCP who all wouldn't order it) to order me 1000mg iron dextran. A few weeks out, I'm already experiencing a reduction in anxiety (especially somatic symptoms like air hunger and adrenaline surges) and a reduction in OCD type thinking and compulsions.

This has got me wondering: have all of my previous med trials been tainted by the fact that my iron and ferritin have run chronically low? My new psych is/was about to try an MAOI with me, but I'm now wondering if I can even call myself treatment-resistant (perhaps one of the previous meds would've helped if my iron was normal when I tried them). And if that's a real possibility, is it worth waiting to see where my levels land before starting something new?

Any input would be immensely appreciated. Thank you!

28M. Diagnosed GAD, health anxiety, ADHD-PI. Post-oncology, in remission, complicated treatment course. Four years of antipsychotic exposure in my early twenties from a diagnosis that was later reversed. Ongoing issues are recurring iron deficiency and anemia, an incisional hernia, and some enlarged lymph nodes.

Target symptom is sympathetic overdrive. Elevated resting arousal, exaggerated startle, constant muscle guarding, poor sleep onset, interoceptive hypersensitivity. Mood is secondary and not what I'm trying to fix.

I've been through most of the standard first-line psychiatric options without meaningful response, plus the usual over-the-counter anxiolytics. Assume the obvious ones have been tried. Currently working with a prescriber on stellate ganglion block, TMS, esketamine, and possibly phenelzine.

What I want from this sub is the adjunct layer. Specifically, anything with evidence for parasympathetic tone or HRV rather than general anxiolysis, and anything worth knowing about interactions if I end up on an MAOI, since that rules out a large share of what usually gets recommended here. Also interested in whether anyone has found anything that helps with interoceptive hypersensitivity in particular.

Please skip anything that raises blood pressure or affects clotting.

28, in remission from stage 4 colon cancer. Treatment at 25 went badly. I was septic more than once, threw clots, had several surgeries, and kept getting C. diff. I was told I might not make it on at least two occasions. Medically I'm mostly fine now. Neurologically I never came out of it. My nervous system still behaves like the threat is live, all day, most days.

Formal diagnoses are GAD, health anxiety, and ADHD-PI, with a PTSD history predating the cancer. Most first-line medications have been tried without much benefit.

Spravato is one of the options on the table. What I'd like to hear is whether it did anything for arousal and startle specifically, or whether the benefit was mostly mood, since nearly everything written about it is framed around treatment-resistant depression.

I'd also like to know how people carrying a lot of medical trauma handled the treatment setting itself. A clinical room with monitoring equipment and a two hour observation period is uncomfortably close to the thing my body is still reacting to, and I'd rather know in advance if that's a problem people have run into.

Practical answers are welcome too. What insurance approval actually required in your case, and how many sessions in you knew whether it was doing anything.

One detail I'm unsure matters. I was on antipsychotics for four years in my early twenties for a diagnosis that turned out to be wrong. If anyone has been told that prior antipsychotic exposure affects esketamine eligibility or response, I'd like to hear it.

I'm 28, diagnosed with GAD, health anxiety, and ADHD-PI. I have traits consistent with several other things but I'm not here to self-diagnose.

Relevant history. PTSD following a traumatic event at 18. Misdiagnosed with schizophrenia at 21 and treated with antipsychotics for roughly four years before that diagnosis was reversed. Treated for stage 3 colon cancer at 25, later restaged to 4, with a course complicated by septic episodes, thromboembolism, multiple abdominal surgeries, and recurrent C. difficile. Currently in remission. Ongoing findings are some enlarged lymph nodes, recurring iron deficiency and anemia, and an incisional hernia.

The presenting problem is that baseline arousal never normalized. Resting state feels like continuous threat monitoring. Exaggerated startle, persistent muscle guarding, difficulty with sleep onset, and trouble distinguishing benign somatic sensation from warning signs. This dominates the picture more than low mood does.

Most first-line options have been trialed without meaningful response. The interventions I'm reading about now are stellate ganglion block, TMS, esketamine, and MAOIs such as phenelzine.

I'm not asking anyone to treat me. What I'd like to understand is how these four are weighed when the target is autonomic hyperarousal rather than depression, whether trauma that is primarily medical and somatic responds differently than interpersonal trauma, whether there's a conventional sequence they get tried in, and whether prolonged unnecessary antipsychotic exposure bears on any of these decisions. I'd also like to know what commonly gets considered at this stage that isn't on my list.