10 Things That Help Me Stay (Mostly) Okay: My AuDHD Mental Health Anchors

Managing My Alphabet Soup

I’ve got quite the alphabet soup behind my name, and I’m not just talking about the MDiv or the PsyD. I mean the diagnostic labels. Autism (“ASD”). ADHD. OCD. GAD. MDD Bipolar. Recovered PTSD. By all accounts, I shouldn’t be okay… and sometimes, I’m not. But mostly, I am, and that’s taken a lot of work (maybe the PsyD in psychology helps me hold all these other letters behind my name with a bit more sturdiness).

It’s Mental Health Awareness Month, and in previous years, this month has done something uncomfortable to me. I’ve tended to put my head down and wait for it to pass. I appreciate the intent, the ribbons, the numbers, the conversations it opens up, and it also makes me sad. The numbers remind me of how much I and the people I love have struggled. Still struggle.

But this year I’m leaning in and sitting with the questions that actually interest me. And the question I’m sitting with this week is: what actually helps me stay mostly okay?

At first, I called this essay “The 10 Things That Have Helped Me Most,” but “most” felt like a lot of pressure, and too definitive. What if I forgot something? What if tomorrow I think, “Oh no, that was actually number four!” So here are 10 things that have helped me, though I’m sure there are others, and I’ll probably think of five more after I hit publish.

And just to be clear: I’m not saying these are the helpful things for all Autistic or ADHD people. I’m a specific person with a specific brain. I’m AuDHD. Some other context about my human psychology: I tend to minimize emotions and lean on hyper-rationality. I’m not great at feeling my feelings in my body. I need my mind to organize and make sense of them, to contain and move through them. So this list reflects my flavor of processing.

Ten Things That Help

1. Understanding Alexithymia

Alexithymia, difficulty identifying and describing emotions, is common among Autistic and ADHD humans. I didn’t have language for this until a few years ago. All I knew was that I didn’t feel things the way others did, especially girls and women. And I felt a lot of guilt about not feeling things “correctly.” It also meant that when I did feel things, it was really intense and I struggled to understand what was happening.

Learning about alexithymia gave me language to understand these experiences and a framework from which I could begin to explore my emotional world in a way that made sense for me.

I always knew that “ideas were my access point to my inner world,” but now I understood why, and I understood how to work with it better. I also became more intentional about tapping into practices that would help draw out emotions: music, journaling, analyzing (but understanding the purpose wasn’t just to analyze but to access). I also started mini-practices of tuning into subtle energy shifts and leaning in with curiosity. Understanding this piece of the puzzle is helping me develop a healthier relationship with these pesky little things called emotions.

2. Understanding My Neurological Makeup (Part One: Autism)

This one truly can’t be overstated. Before my autism discovery, I didn’t understand my spikes of irritability and would judge them harshly. Plans changed — I’d get irrationally upset but know it was irrational, so I worked to hide it, which meant I would then ruminate and stew, and the stress grew. As did the shame. I struggled to connect with others in the way I longed for, but I didn’t understand why (cue more shame and isolation). I spent much of my public life in a dissociative state, fogged out and disconnected, wondering why I just couldn’t get into my experience.

When I came to understand myself as Autistic, there was so much I could contextualize, and yes, also adjust, especially around sensory things. But also in the kinds of work and friendships I pursued, ones that more naturally aligned with my rhythms and brain/body style. I understood that the “bitch with the whip” (the name I gave to my inner critic) was just trying to protect me from shame by beating others to the punch. If I could shame myself enough, she could (mostly) strong-arm me into “correct” behavior. I learned that while she was trying to protect me, I didn’t need her in the same way I had for 37 years. And I’m slowly learning to release her. And in releasing her iron grip, it’s opened the possibility of a new way of relating to myself, one that is more gentle and kind.

3. Understanding My Neurological Makeup (Part Two: ADHD)

The ADHD discovery came later. And to be honest, I’m still unpicking this one. Only recently am I realizing how my executive functioning struggles fuel my overwork, and how hard those patterns are to undo. Undiagnosed ADHD caused a lot of damage in my life, and in ways I carry a lot of shame about. I haven’t moved through all of that yet, and I’m not sure what it will entirely look like.

What I do know is that seeing myself not as an incompetent failure who can’t adult or mother like the rest of them, but as someone with executive functioning challenges, helps at least a little. I can also sense that I haven’t internalized new narratives around this yet, but it’s something I’m working on. In the meantime, understanding ADHD has been massively helpful in my marriage, and that, in and of itself, helps with my mental health. But yeah, this one is still under construction in some significant ways.

4. Mindfulness (The Kind That Isn't Meditation)

Before you close out this essay, let me explain. I don’t mean mindfulness meditation. I mean mindfulness as a way of being: being with myself in a nonjudgmental way. And the ability to zoom out and access meta-cognition (where we become aware of our thoughts and can have thoughts about our thoughts).

Ever since childhood, I’ve always been a very meta-aware person. But it was in learning to become a psychologist that I learned more directly about mindfulness — about how our minds get hooked on thoughts and scripts (because it’s what minds do), and how there are ways we can unhook and notice these for what they are: thoughts. Mental material. This has helped significantly with both my anxiety and depression.

I draw a lot from ACT (Acceptance Commitment Therapy) and Eastern practices. If you want the practical, in-the-flow version of all this, how it actually looks on a regular day, I wrote about that in Mindfulness on the Go.

5. Identity Work

This is a big category and encompasses so much. Discovering the neurological makeup was a part of this. But so are things like diving deep into personality assessments and typology, understanding and developing language around my personality structure, understanding my psychological defenses, exploring dream work and the unconscious, attachment raw spots, and attachment patterns. Engaging in personal therapy has been a big part of this. And my brain naturally gravitates toward this stuff (remember, I process and access my emotions through my mind). And my pattern-recognition brain further enjoys this.

The risk, for me, is that I can use the theory to bypass the feeling. I’ll reach for “well, I do this because I’m an INFJ” and skip right over the actual experience underneath it. I’m getting better at catching myself, and at holding both at once, the insight and the feeling, in conversation with each other.

6. Meaning-Making

My mother modeled meaning-making for me growing up. She got this from her dad, who spent his early years in a prisoner camp during WWII. It was meaning-making born out of trauma and resilience. I got those genes passed on to me, I feel it in my bones. I need hard things to have meaning (and yes, I can see how at times that can lean toward emotional avoidance), but mostly it comes from a space of wanting and needing life to matter. Of seeing how things can both hurt but also be sources of growth, expansion, and ultimately a point where instead of turning toward bitterness, it’s an invitation to lean into goodness.

When loss, pain, or hard things happen, I do work to feel the grief (as best my hyper-rational, alexithymic self will allow… but no really, I’m getting quite good at crying these days). And then the meaning and growth that comes from it is how I either honor the person I’ve lost and carry them with me, or how I allow that painful experience to have mattered in ways that were not just harmful.

This isn’t possible for all events, nor would I prescribe this to others as a blanket statement. But for me, I do know this is one of the most enduring things that has supported mental sturdiness for me.

7. Awe, Transcendence, and Collective Goodness

Awe, for me, is a mix of reverential respect that can get mixed in with fear and wonder. I feel this when I’m immersed in nature, sometimes in ideas, in beauty of all kinds. Awe takes me outside of myself and into something bigger. It is connecting. Which is why I clumped it with transcendence, which speaks to existence or experiences beyond the “normal” or “physical” level. By this I don’t mean God (see next point for clarity), but it could be something spiritual and God-like.

I also think of transcendence as when I tap into collective energy and collective meaning. My mind is at its worst when it is self-focused and at its best when immersed in and part of something bigger than me. Finding those portals into awe, transcendence, and collective goodness is up there with mindfulness and meaning-making. At different times in my life, this has looked different.

8. Leaving Religion

I’ve written and deleted this one ten times. I’m nervous to say it. Other than brief mentions on the podcast, I don’t talk about this one much. And it’s complex because the research is mixed. For some people, religion offers protective measures for mental health (I, in fact, used to research and write about this kind of thing). But in the context of religious trauma, religion can do the opposite. And then sometimes (perhaps often), it’s a mix of both.

I actually see how there are ways my fundamentalist upbringing provided containment around the autism (gave me all the rules and rituals to follow and gave me access to something that felt meaningful). But I also see how it fueled my moral scrupulosity OCD and kept me locked in shame spirals, self-harm, and a pervasively negative view of self. Religion and masking also had a complex relationship because a lot of my social capital was in being a good religious person… well, not always good, I was always a bit rebellious, but I was a deeply thoughtful religious person. (Hello, MDiv from Princeton.)

However, I wasn’t able to do a lot of the identity work and discovery until I left religion. I wasn’t able to get free until I left. The moral scrupulosity is still one of the mental health struggles that causes the most frequent nervous system hijacks and disruption to my life, but since leaving religion, I hold these experiences differently. But I also have more existential anxiety and have needed to carve out other ways of accessing awe and transcendence. Keeping some spiritual practices that I hold loosely has also been part of this.

This one… it makes the list, but it’s complex. And I also know that for other people, finding religion and religious community would be on their list of things that support their mental health. And I also recognize that white experiences of religion can differ greatly from Black and Brown religious communities, many of which were born from collective liberation. I’ve been part of those communities, and I suspect that if I were still connected to them today, my perspective on this point supporting my mental health would feel different. It’s important for me to make space for these nuances, even as I write about how leaving religion has been helpful for me.

9. Writing

I often don’t know what I feel until I write about it. I often don’t know what I think about an issue until I’ve researched and written about it. This goes back to alexithymia and the way I process my inner world. Even back in high school, I’d spend hours locked in my room listening to Linkin Park on repeat, writing or drawing in my journal. After losses, I’d make a journal dedicated to that person where I’d continue to write to them, or paste together all the letters we’d ever written back and forth.

Writing has connected me to other humans whose inner worlds are similar to mine. It’s carved out hidden trails where I can both connect more deeply to my inner world but also to the inner worlds of other people like me — people who, if we met in a coffee shop or at the market, we’d likely both be too dissociated or shy to actually connect.

10. Psychoeducation (Education About the Mind)

Psychoeducation is just information about ourselves. Basically, it’s a structured educational approach that is often used in mental health settings to help people understand their mind, body, mental health conditions, and how to work with it.

As an early therapist, I leaned heavily on psychoeducation, probably because of how effective it was for me.

Once I understood the lethargy cycle in depression, I knew how to work with it.
Once I understood the tricks of the depressed mind, I could catch them and they had less power over me.
Once I understood the mechanics of the nervous system, I recognized what was happening when cortisol spiked and knew what to do.

I need to know the “why” before I can act. I won’t do a breathing exercise unless I get the physiology behind it. And I won’t even touch a cognitive exercise for chronic pain until I understand how my thoughts and nervous system work together, how certain thoughts can either trigger danger signals or accidentally amplify the pain.

I needed to understand how sleep impacts mood and neurotransmitters and memory to get on board with the obnoxious sleep hygiene practices (actually, I still struggle with that one). I needed a framework for understanding energy and mood intensities to know how to work with big shifts. Psychoeducation, and more deeply understanding my body has been hugely beneficial.

What's On Your List?

That’s my list, or at least today’s version of it. I’ll probably think of five more by tomorrow.

What strikes me is how specific it is. It’s not a list I could have written at 25. It’s not a list I could write for you. It’s a list for this particular brain, shaped by this particular life. I don’t think that’s a disclaimer so much as the actual point.

The things that help our mental health tend to be specific, stubborn, and occasionally contradictory. They sometimes include things we were told were bad for us, and exclude things we were told should help. That’s not you being difficult. That’s you being a specific person with a specific brain.

Which, it turns out, is what staying mostly okay actually looks like. That’s certainly how it looks for me.

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