I do not want to diminish the importance of your perspective in any way, only to add that some in the #1 camp are teetering on the brink of "able to take care of self" and not withholding help to be cruel, but because they think helping might pull them over the cliff, too.

Wellness has big steps sometimes, and if you tumble down a step it may take a long time to get back up, and your ability to help yourself, and anyone else, will be diminished.

I know. I do not blame people. At least not for that.

What I blame people for is shaming, infantilizing, and treating people who struggle like nutjobs worthy only of ostracization for "refusing to accept help".

Acting "whiny" is almost universally seen as extremely repulsive, and nobody would act this way if they weren't genuinely helpless - whether perpetually or only in the moment.

> nobody would act this way if they weren't genuinely helpless

That seems like too much of a generalisation. The issues you describe are real and that is not diminished by the fact that some people operate differently from what you imagine makes sense.

I do want to diminish the importance of GP's perspective. It's a lazy and tired answer to the problem, and quite frankly - Offers a direct confirmation of the top level post's point rather than a refutation. "unmedicated ADHD and chronic fatigue"? Really? They're a nutjob. How has discourse gotten to the point where we're all so afraid of hurting the feelings of the fringe that we can't point out the obvious? Being dismissive is precisely what we should be doing.

Personal attacks will get you banned here. So will taking HN threads into hellish flamewar and then fueling it further. You can make your substantive points without doing either of those things.

If you'd please review https://news.ycombinator.com/newsguidelines.html and stick to the rules when posting here, we'd appreciate it. We've had to ask you about this kind of thing more than once before.

I can see where you are coming from. At my work for instance, we will take on those with good people skills and the intelligence to learn the technical skills they are missing. We are reluctant to do it the other way round. We avoid those who have the technical skills but not the people skills because common wisdom and experience indicates it is much harder to teach the people skills… I would add that we are not equipped to help them get up the curve. The thought process is that once you teach someone able a technical skill, it generally sticks. Soft skills tend to be harder to teach and problems recurring in nature…this results in time sinks. This might be perceived as unfair but it is a reflection of the world we live in…and generally they are practical observation. People and businesses need better tools/methods/education to help people but right now there is little incentive to do so…we, as a society, are more focused on gender and racial equality than mental health equality.

On a personal level, if I have to invest too much of my time or energy managing someone else’s emotional state on an ongoing basis…then I’m not interested in maintaining that relationship. Maybe because I was once in a toxic, draining relationship which almost destroyed me..I am maybe more alert or sensitive to these issues.

This is valid and I don't blame you. Over the years, I've experienced both sides of that coin, and nobody could be rationally expected to put up with it.

But it sure hurts to have spent a decade unable to leave my house or take basic care of myself while continuously being told I'm exaggerating, making it up, just lazy, and worse, by people who couldn't even imagine just how bad my issues are.

I don't think I will ever get over the trauma of either how helpless I was, or how people treated me.

From my perspective, "it's mental health" seems like a throwaway diagnosis meant to get a patient to go and listen to a therapist, take their pills, and fit into society a little better.

Based on my knowledge, I firmly believe that a lot of the perpetually mentally unwell people - especially ones experiencing sleep disorders, GI distress, and other chronic ailments - likely have an underlying physiological condition responsible for their predisposion to mental disorders.

To echo one of the earlier posts: I’m in group 1, but only just. I have spent multiple months of my adult life barely leaving the house, unemployed, curled up in bed, in a seemingly endless cycle of anxiety and struggling to cope. I could literally feel my mind and body atrophying.

Today I’m sort-of functional in that I show up to work every day, get most of my tasks done, and pay the bills. But I have very poor executive function and I’m really scared of dropping off the deep end again. Stories like yours scare me and inspire some disgust because I see the same tendency in myself and I don’t want to go there.

I also know that practically speaking prolonged engagement/discussion with someone having such issues is unlikely to help. Nor is providing suggestions or blame. There’s not much anyone can do. The best I can offer is, if there was ever a period of your life where you were happier or more functional, can you see how to switch to that mode again? And if there’s one big thing blocking you (the fatigue, in your case), maybe there’s a one-time action you can perform, like going to a doctor, that could help.

I’m not offering this advice to you specifically but just to anyone who might feel similarly stuck.

There were periods in my life when I coped better, but I have never been able to function in my life until I was lucky enough for a friend to just buy me a bilevel CPAP, at a point in life when I couldn't even go out and see a doctor anymore.

Even now, I can barely work 1-3 hours a few days per week, and not starve myself while waiting for a consultation with an orthognatic surgeon.

I am aware I could do better mentally, but at the end of the day, it's difficult to cope with being unable to achieve even simplest goals I set for myself, and the crippling loneliness of nobody believing that yeah, I'm really sick, really struggling, and really not managing very well.

If your EF impairments are unremitting, it's likely that you have an underlying physiological condition. Can I ask you about the status of your sleep, digestion, and presence of any chronic health complaints, however trifle(like chronic cough, waking up grumpy, or mild indigestion)?

Yeah mental health is really a catch-all term and it is much more complicated than that since the body and the mind are intertwined.

On people not listening nor understanding and making remarks about making it up or being lazy, it is hard when one's feelings and thoughts are not being validated.

I'll just have to do a counterrant in the hopes it can be useful, it's one word: ayurveda.

Seek it if you feel like, but basically I predicate it on the thought modern pharma is very much trying to hit above its weight class and mental health medicine is clueless, and illiterate about the body, and AHDH is in ancient terms deeply related to vata issues, the which chronic fatigue only confirms as the real cause. Modern world is a hot vayu airy mess but I'll vent no further.

Mental health medicine absolutely IS clueless. The explanations of why meds work make no sense, research on side effects is neglected, mechanisms are not understood. That said, stimulants are /something/ of an exception, in that they very directly counter the deficits - if not the causes - and improve essentially all outcomes.

Have you by chance ever considered your symptoms as dissociation? As in symptom of and underlying complex trauma which possibly was retraumtized aka reactivated later?

I know exactly what is wrong with me. ADHD is not trauma, and my chronic fatigue is caused by airways so narrow that I cannot brestje if I straighten my neck. Even sleeping on a BiPAP, every single of my breaths is flow limited and I wake up(partially, not into wakefulness) because of it at least 7-15 times an hour.

Also, PTSD is the single disorder with the highest rates of underlying physiological risk factors. Even studies only screening for sleep apnea(most younger people present as UARS) find 30-70% prevalence, sleep disorders predict long term outcomes more accurately than the underlying traumatic events, and 2/3 of people do not develop PTSD or CPTSD following trauma.

Most likely, undiagnosed UARS/apnea is present in majority of people with chronic sleep issues, and together with other physiological risk factors(early insulin intolerance, severe gut dysbiosis, thyroid problems, others) makes up the bulk of psychological illness.

The reason why things look purely psychological is because the human mind revolves around spinning narratives explaining both own and other people's experiences in terms of events and decisions.

It's only one of the things. And executive dysfunction does not justify abuse.