u/cathartic_cosmos

Hello! I’ll be testing soon for my Advanced Alcohol and Drug Counselor (AADC) credential. I’ll also be transitioning into a new role soon, which will involve a lot of involvement in our MAT program.

Although facilities in my state seem to prefer people have their AADC credential, it’s not a requirement, and most places don’t offer more pay for having it. I know the value in being credentialed and I know it can open up opportunities, but I’m trying to work up the nerve to push for increased pay once I’m credentialed (hardly anyone else in my organization has it…only one other, in fact).

For you, how has the AADC or CAADC benefitted you, made you more appealing as a provider, aided you in the work you do, etc.? I’m having a difficult time figuring out how I want to present this! I’d love any help I can get.

Thank you!

Hello! I’ve been researching possible alternatives to The Matrix Model. I’m wondering if any of you have suggestions? The few SUD treatment facilities I’ve worked at love TMM (including the one for adolescents), and I certainly see the value, but it feels dated. This isn’t necessarily a problem, as the information and content are still relevant and valid, but I’m putting feelers out!

Thank you!

Hi! I know there are ways to get medication shipped to you if you live in a state where abortions are banned/illegal. How safe is this? I’m in WV. If I order medication, what’s the likelihood I’ll get “caught” based on what’s being shipped? I don’t know if packages are scanned to show what is inside of them or if there are potentially “signs” that are looked for. I did read they’re shipped discreetly, but I’m experiencing a lot of anxiety about the process and wanted to ask about it here. Are there any particular places that ship more safely/discreetly than others, or are they basically all the same? (Ie: MAP, ChoicesRising, Southern Woven, etc.)

TLDR: We know misdiagnosis (prior to correct diagnosis) is really common in people with ASD, especially women who aren’t diagnosed until well into adulthood. Mine were: OCD, Major Depressive Disorder, Social Anxiety, Generalized Anxiety Disorder, Adjustment Disorder, Bipolar Disorder, Borderline Personality Disorder, and PTSD (CPTSD). None really “made sense” and I think are all really common ones that autistic people initially get (not negating co-morbidities). In my 30s, I was finally taken seriously, and here we are: AuDHD. What were YOUR misdiagnoses, if you had any? What was your journey/experience like?

I was recently reflecting on my mental health history, as well as what that has looked like regarding psychiatric treatment.

🔘As a child, unofficial labels/diagnoses: obsessive-compulsive tendencies, social anxiety, and I was frequently called into the guidance counselor’s office in elementary school, due to “odd behaviors.”
🔘As an adolescent, Major Depressive Disorder (with NSSI/SI) and Generalized Anxiety Disorder.
🔘In my later teen years, a therapist wanted to diagnose me with Bipolar II Disorder (due to my sensitivity, overstimulation, bursts of hyperfocus/motivation, then crashes, etc.).
🔘A couple of years after that, I was diagnosed with Borderline Personality Disorder (based on my history of NSSI, SI, and rocky relationships). Then, Adjustment Disorder.
🔘My mid-20s: Persistent Depressive Disorder, Generalized Anxiety Disorder, PTSD, and “no personality disorder, but traits of Borderline Personality Disorder and Avoidant Personality Disorder.” (Ironically, this set came from me seeking a diagnosis for what I felt like might be ADHD, ASD, or both - and an assessment wasn’t done for either “because I had good grades in school when I was a child.”)
🔘 I’m in my mid-30s now, and it has only been within the last 3 or 4 years that ADHD was finally diagnosed, and the last 2 that ASD was finally unofficially diagnosed (by my psychiatrist who has been working with me for years, but he doesn’t do “official” assessments and recommended I go out of state for it…which I can’t afford).

I’m a woman, so I suspect that played a role in some of my misdiagnoses (plus, I from the Appalachian mountains). I was very high-masking to most until around 2020/2021. I also spent a lot of time being dismissed, having assumptions made about me, etc. Only recently have I started to heal and unpack how some of those labels really messed with me, confused me, and invalidated my lifelong experiences. BPD, for example (ie: I had rocky relationships because I kept getting into abusive ones, not because I was turbulent…and I later realized that much of the NSSI had to do with sensory input and overwhelm). I also spent the biggest chunk of my life trying to “fix” myself, wondering why all of my effort with standard therapy, psychotropics, emotional regulation, social skills, etc. seemed to fall flat or do well for a while, then “fail.” Why couldn’t I just be okay, “normal,” solve all of these problems? Why were doctors always perplexed and throwing a multitude of labels at me?

I know a lot of people have stories like mine. I would love to hear yours! What is your story? What were you misdiagnosed with? What has your journey been like?

TLDR; 6 yr relationship together - has been rocky. Not because of any significant infractions, but because of lack of communication, connection, conversation, etc. Feel selfish about ending it, but don’t know what to do.

This is a long read. I’m just kind of stuck. I feel like typically, I navigate interpersonal dynamics fairly well, but I’m struggling here.

Was in a relationship for 5 years (pseudo 6 1/2). Initially, we “talked” for a few months and at first, my partner was really into everything, super communicative, wanted to spend time together, they were emotionally expressive, etc. Then, my partner’s depression impacted them pretty significantly and everything changed. It led to them withdrawing, being short, sometimes being unkind, getting annoyed easily, displacing blame, often feeling apathetic, etc. We stopped seeing each other, but remained friends. After a while, they started medication and it helped substantially; they realized they had acted and felt that way because of depression and wanted to be with me. For a couple of years, this continued and everything was great. There were rocks, sure, but the effort was there.

I want to start this next bit out by saying my partner isn’t one for communication, conversation, etc. I had figured this out and “accepted” it. Everyone is different. I spent a lot of time adapting myself to certain parts of the relationship, because I saw that as necessary. For me, so long as there were “blips” of effort, it felt like enough. I didn’t expect some major change, as it was something he just seemed to struggle with. Whenever his meds worked effectively, this tended to go better. He had the capacity to engage and interact some. Outside of that, we enjoyed our time together. I was generally the one arranging things for us to do, putting the work in to initiative conversations, trying to branch out with him, etc. He wanted that and loved it. Eventually, he moved in with me.

After a couple of years together, medication stopped working as well. Slowly but surely, his irritability came back. I would talk and mostly be met with silence. Communication in general became minimal. We got a dog and that seemed to be a big turning point - he didn’t have the patience for a puppy and was perpetually angry, would yell, seemed frustrated with me at all times, and adjusted poorly to the changes we had to make in our life and with our routines. I struggled some, too, but mostly with routine changes and CPTSD getting triggered by his own outbursts. After that, things seemed to especially go down hill (he’s bffs with the dog now and not super angry all the time now, but our relationship suffered greatly). After that, some more years passed.

Sometimes I felt like a ghost, merely existing. I also started to feel like I was trying to hold everything together. I became increasingly lonely, and as my stress and health problems compounded, my own depression became pretty significant again. I got much of that under control and ended up making more friends, which was great. Except, when I made those friends, I realized just how isolated and lonely I had really become. I also hadn’t been aware of how much my self-esteem and self-worth had taken a hit during the several years I had been with my partner. Due to his depression, most affection stopped, I eventually started to feel like a bother because of the irritability and minimal response when I would speak, and aside from birthday and anniversary cards, words of affirmation were absent. I guess all of this combined just took its toll. So, I decided to focus on that, work on myself, and find “me” again.

Which worked wonderfully. Succeeding at work and being around coworkers and friends that I felt “human” around further helped me realize how small I had become in my relationship. Throughout the relationship, I had communicated needs and encouraged him to as well, but little improved. About a year ago, I chose to end the relationship. What resulted was more of a “separation,” and we continued to live together. He wanted to work on things and acknowledged that he had kind of left me to fend for myself in the relationship, though not intentionally. He also admitted to feeling like I was better than him, being insecure, and that ultimately fueling some of his irritability and certain behaviors with me over the years. Him admitting that was a big deal and he wanted to work on that, foo.

For the first few months, he put in extra effort. Almost obsessively, which ultimately, was off-putting. Suddenly, I couldn’t breathe and felt like my every move was being scrutinized. Because of this, I stayed with friends fairly often; being home caused too much anxiety and I had zero space. He backed off some, and we started to reconcile. I could tell he was “trying.” However, that quickly changed and started to go back to how it was before.

Now, at this point (today), we’ve been doing the same dance for nearly a year, with it becoming progressively worse and we’re more like roommates than anything.

A bit more information: I’m not extremely chatty, and I do enjoy silence. However, I value open communication and being able to have conversations when the need or want arises (typically, during more important or serious conversations, he has been prone to shutting down, defaulting to self-defeating talk, or getting mad). Either in person or via text, it doesn’t matter to me. I just appreciate that human connection. I wouldn’t say I “require” a lot, but I need *something.* I never expected him to be a different person, and he verbalized wanting to improve his communication skills all around. I’m autistic and have ADHD, and while not diagnosed, I wouldn’t be surprised if he is also neurodivergent. I’ve tried to keep this in mind as well. And despite everything, he has tried to show his love and care via acts of service and gifts. He has always done that, which I appreciate and value. I understand he is more likely to do that rather than talk or anything else. Throughout his depression, I’ve stuck by his side. And whenever I was struggling with mine and health issues, he stuck by my side. We absolutely do love and care about each other.

But more and more, I feel like I *need* open communication, conversation, and connection. He’s saying that although he has tried, it’s just not something he can do or keep up with. We’re talking about ending things officially and him moving out. I wish I were being dramatic or exaggerating, but we’re gone days with barely any conversation, even when I’m trying (very hard). So much so that if he didn’t say otherwise, I’d have no idea he even likes me. And at the end of the day, though we’re been together/involved for 6 years now, he hasn’t shared a lot with me. Most of what I know is from observation, digging, being perceptive, etc.

Neither of us knows what to do. We don’t want things to be this way, but it seems to be something that just “is.” That sucks and it hurts. I’ve been grieving for a year and honestly, even longer, because I watched everything collapse and couldn’t stop it. He has tried other medications, and nothing is all that effective. In general, he’s not happy and is just going through the motions, and has done that for most of his life.

Breaking up feels ridiculous whenever you still love and care about each other. I also feel so selfish for wanting/needing more. For years, I wanted acts of service/gifts to be enough. I tried to keep in mind that was him and that’s how he was showing he loved me - that I didn’t need to talk, verbal affection, or to do a lot together. I tried to keep in mind that is irritability and lack of engagement were depression - not him. Still, life got lonelier and lonelier. How can you have a relationship if you don’t talk, engage in anything, and you can’t even communicate about important, serious, or heavier topics? He went to a few therapy sessions last year, but dropped from it. Medication doesn’t really help with his depression at this point (and even when he isn’t depression, he still struggles with a lot of this).

I don’t know what to do. Breaking up feels like something that happens when you don’t get along, things are really bad, someone did something significant, etc. Not over this. I feel confused and selfish for wanting/needing something more. Six years together is a long time to spend together for it to come to this. Am I looking at this faultily? Is there anything I can do? Is there anything we can do?

This is a long read. I’m just kind of stuck. I feel like typically, I navigate interpersonal dynamics fairly well, but I’m struggling here.

Was in a relationship for 5 years (pseudo 6 1/2). Initially, we “talked” for a few months and at first, my partner was really into everything, super communicative, wanted to spend time together, they were emotionally expressive, etc. Then, my partner’s depression impacted them pretty significantly and everything changed. It led to them withdrawing, being short, sometimes being unkind, getting annoyed easily, displacing blame, often feeling apathetic, etc. We stopped seeing each other, but remained friends. After a while, they started medication and it helped substantially; they realized they had acted and felt that way because of depression and wanted to be with me. For a couple of years, this continued and everything was great. There were rocks, sure, but the effort was there.

I want to start this next bit out by saying my partner isn’t one for communication, conversation, etc. I had figured this out and “accepted” it. Everyone is different. I spent a lot of time adapting myself to certain parts of the relationship, because I saw that as necessary. For me, so long as there were “blips” of effort, it felt like enough. I didn’t expect some major change, as it was something he just seemed to struggle with. Whenever his meds worked effectively, this tended to go better. He had the capacity to engage and interact some. Outside of that, we enjoyed our time together. I was generally the one arranging things for us to do, putting the work in to initiative conversations, trying to branch out with him, etc. He wanted that and loved it. Eventually, he moved in with me.

After a couple of years together, medication stopped working as well. Slowly but surely, his irritability came back. I would talk and mostly be met with silence. Communication in general became minimal. We got a dog and that seemed to be a big turning point - he didn’t have the patience for a puppy and was perpetually angry, would yell, seemed frustrated with me at all times, and adjusted poorly to the changes we had to make in our life and with our routines. I struggled some, too, but mostly with routine changes and CPTSD getting triggered by his own outbursts. After that, things seemed to especially go down hill (he’s bffs with the dog now and not super angry all the time now, but our relationship suffered greatly). After that, some more years passed.

Sometimes I felt like a ghost, merely existing. I also started to feel like I was trying to hold everything together. I became increasingly lonely, and as my stress and health problems compounded, my own depression became pretty significant again. I got much of that under control and ended up making more friends, which was great. Except, when I made those friends, I realized just how isolated and lonely I had really become. I also hadn’t been aware of how much my self-esteem and self-worth had taken a hit during the several years I had been with my partner. Due to his depression, most affection stopped, I eventually started to feel like a bother because of the irritability and minimal response when I would speak, and aside from birthday and anniversary cards, words of affirmation were absent. I guess all of this combined just took its toll. So, I decided to focus on that, work on myself, and find “me” again.

Which worked wonderfully. Succeeding at work and being around coworkers and friends that I felt “human” around further helped me realize how small I had become in my relationship. Throughout the relationship, I had communicated needs and encouraged him to as well, but little improved. About a year ago, I chose to end the relationship. What resulted was more of a “separation,” and we continued to live together. He wanted to work on things and acknowledged that he had kind of left me to fend for myself in the relationship, though not intentionally. He also admitted to feeling like I was better than him, being insecure, and that ultimately fueling some of his irritability and certain behaviors with me over the years. Him admitting that was a big deal and he wanted to work on that, foo.

For the first few months, he put in extra effort. Almost obsessively, which ultimately, was off-putting. Suddenly, I couldn’t breathe and felt like my every move was being scrutinized. Because of this, I stayed with friends fairly often; being home caused too much anxiety and I had zero space. He backed off some, and we started to reconcile. I could tell he was “trying.” However, that quickly changed and started to go back to how it was before.

Now, at this point (today), we’ve been doing the same dance for nearly a year, with it becoming progressively worse and we’re more like roommates than anything.

A bit more information: I’m not extremely chatty, and I do enjoy silence. However, I value open communication and being able to have conversations when the need or want arises (typically, during more important or serious conversations, he has been prone to shutting down, defaulting to self-defeating talk, or getting mad). Either in person or via text, it doesn’t matter to me. I just appreciate that human connection. I wouldn’t say I “require” a lot, but I need *something.* I never expected him to be a different person, and he verbalized wanting to improve his communication skills all around. I’m autistic and have ADHD, and while not diagnosed, I wouldn’t be surprised if he is also neurodivergent. I’ve tried to keep this in mind as well. And despite everything, he has tried to show his love and care via acts of service and gifts. He has always done that, which I appreciate and value. I understand he is more likely to do that rather than talk or anything else. Throughout his depression, I’ve stuck by his side. And whenever I was struggling with mine and health issues, he stuck by my side. We absolutely do love and care about each other.

But more and more, I feel like I *need* open communication, conversation, and connection. He’s saying that although he has tried, it’s just not something he can do or keep up with. We’re talking about ending things officially and him moving out. I wish I were being dramatic or exaggerating, but we’re gone days with barely any conversation, even when I’m trying (very hard). So much so that if he didn’t say otherwise, I’d have no idea he even likes me. And at the end of the day, though we’re been together/involved for 6 years now, he hasn’t shared a lot with me. Most of what I know is from observation, digging, being perceptive, etc.

Neither of us knows what to do. We don’t want things to be this way, but it seems to be something that just “is.” That sucks and it hurts. I’ve been grieving for a year and honestly, even longer, because I watched everything collapse and couldn’t stop it. He has tried other medications, and nothing is all that effective. In general, he’s not happy and is just going through the motions, and has done that for most of his life.

Breaking up feels ridiculous whenever you still love and care about each other. I also feel so selfish for wanting/needing more. For years, I wanted acts of service/gifts to be enough. I tried to keep in mind that was him and that’s how he was showing he loved me - that I didn’t need to talk, verbal affection, or to do a lot together. I tried to keep in mind that is irritability and lack of engagement were depression - not him. Still, life got lonelier and lonelier. How can you have a relationship if you don’t talk, engage in anything, and you can’t even communicate about important, serious, or heavier topics? He went to a few therapy sessions last year, but dropped from it. Medication doesn’t really help with his depression at this point (and even when he isn’t depression, he still struggles with a lot of this).

I don’t know what to do. Breaking up feels like something that happens when you don’t get along, things are really bad, someone did something significant, etc. Not over this. I feel confused and selfish for wanting/needing something more. Six years together is a long time to spend together for it to come to this. Am I looking at this faultily? Is there anything I can do? Is there anything we can do?

Hello!

I have come to terms with the fact my current pregnancy is non-viable (I’m heartbroken and emotionally tired, but trying to be realistic). However, I’m struggling with understanding what’s going on.

TLDR: HCG definitely suggests non-viable pregnancy. Yesterday, went to ER with intense pain and bleeding. Today, not as much pain and little spotting/bleeding. Still having pregnancy symptoms. Ultrasound results from yesterday don’t make sense…ER staff allegedly observed gestational sac intrauterine, the size it’s supposed to be for 5w2d. Indicated a “suggested fetal pole” was observed. My HCG betas, at their highest, got to 125 - that was Friday. I’m under the impression there’s basically zero possibility for them to have seen a gestational sac, especially one big enough for 5w2d, and certainly not a fetal pole. Now I don’t know what to make of the results, the pain I experienced, what’s going on in my body, etc.

LMP: 4/17; 1st HCG: 68 on 5/18; 2nd HCG: 116 on 5/20; 3rd HCG: 125 on 5/22 & 8 progesterone; 4th HCG: 116 (different lab)

Evening of 5/21, I began experiencing bad pain in my lower right pelvis. This led to bad sciatica pain that radiated through my entire right leg and caused numbness in my right lower back and the upper part of the right side of my butt. Light brown spotting began. Throughout the day on 5/22 and 5/23 pain and bleeding were intermittent, leg pain progressed. Evening and night of 5/23 and morning of 5/24, pain intensified a lot and became way more consistent. Bleeding picked up. There was minor clotting and bleeding varied between dark brown, brownish red, crimson brown, pink, and bright red. Right pelvic pain aside, I also experienced generalized pelvic pain and some on my left side as well, but it was most intense on the right.

Potentially important details:
▫️Prior to this, whenever I experienced what I assume was implantation and early pregnancy cramps, much of it seemed to be on the left.
▫️I have endometriosis; I know there is a lesion on my right pelvic wall.
▫️I had a chemical pregnancy during my last cycle.
▫️I’ve still been having pain today, though it isn’t as bad. I do feel it more if I move around much. Some generalized pain, but pinching and aching on my right side and lower right pelvis. Since yesterday afternoon, spotting has been present, but minimal. Tenderness if there’s pressure applied to my right pelvic area.

Because of how bad the pain got yesterday, I went to the ER (my most recent HCG of 116 was taken there). They completed an ultrasound. Afterward, they told me they found a sac in the uterus, so there were no concerns about it being ectopic. They mentioned a lack of cardiac activity, so told me it wasn’t viable. Said to follow up with my OBGYN, then sent me on my way.

In the moment, I was confused about some of the statements, but later on, I looked at my ultrasound report. They reported they identified a likely gestational sac of 6x6x5mm, in line with my pregnancy at 5w2d. They also mentioned they found a suggested fetal pole, no cardiac activity. Confirmed intrauterine. ⭐️Less important details: normal shaped uterus with 12mm heterogeneous endometrium; left ovary of normal size (23x16x24mm) with a 10x9x9mm anechoic simple cyst, and left ovary of normal size (20x20x23mm), unremarkable (they put left on both, so I don’t know which is which). The end, no other details, support, etc. I kept prodding, but the doctor just kept telling me that’s what they saw.

I’ve reached out to my OBGYN with all of this information, but they aren’t in the office until tomorrow. They’ll have me do another HCG draw tomorrow, I assume. For now, though, I’m perplexed and wound up with way more questions than answers. I’m thinking perhaps a cyst ruptured and led to the pain and inflamed the endometriosis in my right pelvic area, but I know there are a lot of other possibilities here, too.

***This same doctor told me none of my leg or hip pain could be related to my pelvic pain, since “they’re different structures.” I thought that was wild, because I regularly have leg and sciatic pain from ovulation and menstruation. He also acted shocked there wasn’t any cardiac activity or fluttering on the ultrasound, despite me only being around 5 weeks pregnant (again, with such low HCG, I know it’s not viable…but…even if it were, seeing cardiac activity and fluttering at 5 weeks would be more surprising, I’d think). Then he left the situation telling me I’m in Gods’ hands now. The experience was/is distressing.***