What I Can Speak To
After last week’s blog discussing how different mental health conditions affect the brain in general, I wanted to talk about my own personal experience with these issues, what it has felt like, and how it is often misunderstood.
There are countless combinations of diagnoses that people live with, and I cannot speak to most of those combinations specifically. I am not a clinician, and I will never pretend to fully understand experiences I have not experienced myself. I plan to do much more research and possibly interviews before writing about other diagnoses. But I can speak honestly about what my own brain has gone through and what it is still navigating.
Over the years, I have been diagnosed with several conditions, including Major Depressive Disorder, Severe Anxiety, CPTSD, and ADHD. I have a medication that has been treating my depression well for several years now. However, the three that affect my day-to-day life the most are ADHD, severe anxiety, and CPTSD. I sometimes refer to them — somewhat sarcastically — as my “Perfect Hot Mess Trifecta.”
Many times people do not understand why I react a certain way, forget something important, or respond oddly to situations. Sometimes I lose track of what I was saying mid-conversation. Sometimes I become overwhelmed faster than most people. Sometimes my brain seems to freeze when I am under stress.
I also still experience some lingering effects from what is often referred to as “brain fog,” which I will likely talk about more in next week’s blog.
Trying to explain what is happening in those moments — especially in the middle of a heated conversation — is nearly impossible. To someone on the outside, it can sound like an excuse. But it is not an excuse. These reactions are tied to very real neurological and psychological processes happening in the brain when trauma responses, anxiety, and executive functioning challenges are colliding.
In the following sections, I will explain how these three conditions interact in the brain, what happens when they overlap, and what it looks like for me to live with that combination.
Brain Function — When ADHD, Anxiety, and CPTSD Interact
Because I explained the science behind these diagnoses individually in last week’s blog, I will not go into the same level of detail again here. However, understanding how these systems interact helps explain why the overlap can feel so chaotic.
A detailed list of symptoms that can occur when these conditions overlap is included in the Appendix at the end of this blog. And going through the list, there wasn’t many that I haven’t experienced to some extent.
ADHD, severe anxiety, and CPTSD each affect different systems in the brain. ADHD primarily affects executive functioning — the brain’s ability to organize, prioritize, initiate tasks, and regulate attention. Severe anxiety activates the brain’s threat detection system, keeping the nervous system alert and scanning for potential problems. CPTSD develops when the brain has adapted to prolonged trauma or instability, strengthening survival responses such as hypervigilance, emotional sensitivity, and rapid stress activation.
When these systems activate at the same time, the brain can feel like it is receiving competing signals from multiple directions, a total train wreck. Thoughts may continue racing while -the ability to focus disappears. Tasks may feel urgent — even when they are not — but starting them becomes difficult. Emotions can intensify quickly even when I am trying to remain calm.
From the outside, this can look confusing or inconsistent. From the inside, it can feel extremely frustrating. These reactions also do not happen randomly. The topic causing the issue may seem random though. And they often appear during moments of emotional pressure, cognitive overload, or situations that trigger stress responses; situations such as heated conversations, feeling overwhelmed by too many tasks, burnout from stress, or reminders of past trauma.
In those moments, the nervous system can quickly shift into survival mode. When that happens, the brain prioritizes managing stress rather than organizing thoughts or responding calmly. That is why reactions can sometimes appear disproportionate from the outside.
Misunderstanding of Symptoms
One of the most difficult parts about living with the overlap of ADHD, severe anxiety, and CPTSD — aside from the symptoms themselves — is how easily those symptoms can be misunderstood.
From the outside, someone may see forgetfulness, distraction, emotional reactions, speech disruption, or difficulty finishing tasks and assume it means a person is careless, irresponsible, overly sensitive, not trying hard enough, or worse. But often that is not what is actually happening in these situations. In reality, trying to function normally while managing these symptoms requires an enormous amount of mental energy.
Trying to explain this in the middle of a stressful moment is nearly impossible. By the time you are trying to explain it, the nervous system is already activated, and the brain is operating from survival mode. After Dustin’s death is when this really came to fruition. I hadn’t had these issues prior (at least not to the point it was negatively affecting daily life). Finding someone you love deceased is a trauma that fundamentally changes how the brain processes stress, emotion, and memory. Of course I was acting differently — anyone would be. What happened, quite literally, changed me into a new person. I have talked about learning to walk on new legs. I am totally different than I was before. And that is okay. If other people don’t like my new personality, that is their problem. I am doing the best I can with what I got.
There were moments when my thinking slowed down, and at times my speech became less clear or organized than usual, although I did not realize it. When the brain is overwhelmed by stress or trauma responses, language processing can temporarily become disrupted, which can cause speech to sound slurred or disorganized. To someone unfamiliar with these neurological responses, that can easily be misinterpreted. I can’t tell you how many times I have had to ask Justin where we were when I woke up in my own home, but that severe of symptoms, totally fogged, was more in the beginning. However, I still wake up and ask what day it is or if we have to do anything (is it even a weekday?), it takes a good amount of time for my brain to function in the morning. It’s incredibly frustrating, and I was really self-conscious about all these things, but now I know why it’s happening.
In my case, certain close friends assumed I had relapsed. That assumption was incredibly painful, especially considering how hard I was fighting to stay sober, while grieving. I was hiding my feelings, so I wasn’t “Debbie Downer” at their wedding event, a few months after his death. Of course I wasn’t myself or what they knew as myself. What hurt the most was that they just talked about it behind my back instead of coming to me with concern. That’s not a true friend. What was actually happening was that my nervous system was overloaded and my brain was trying to process a trauma it had never experienced before, while trying to fake it to make it.
When people do not understand what is happening in the brain, they often fill in the gaps with their own assumptions. However, those assumptions can cause real damage. I had to cut a lot of ties to keep my sanity through this process. And it is for the best.
“I am exhausted from trying to be stronger than I feel.”
— Unknown
Treatment and Regulation
Understanding what was happening in my brain was an important first step, but understanding alone does not automatically solve the problem. Regulation takes time, effort, and the right support. Over the years, I have worked with professionals who helped me better understand how these diagnoses affect the brain and how to manage the symptoms that come with them. Therapy has been an important part of that process, along with appropriate medication for my situation. And it is still improving every day.
“There is hope, even when your brain tells you there isn’t.”
— John Green
Structure and routine have also become important tools. ADHD in particular makes organization and beginning tasks more difficult, so learning strategies that support executive functioning can make a meaningful difference. Things that may seem simple to others — writing things down, creating structure, slowing down during stressful moments — can be extremely helpful to function.
Learning about nervous system regulation has also been valuable. When anxiety or trauma responses activate, the brain shifts into survival mode. In those moments, the goal is not perfection. The goal is simply bringing the nervous system back to a regulated state so the brain can think clearly again.
Education has also been a major part of my healing process. Through counseling, recovery, certifications, and the research I continue to do each week, I have gained a much deeper understanding of how trauma, anxiety, and ADHD interact. The more I learned, the more things that once felt frustrating and made me feel like I was literally broken, finally began to make sense.
When shame is replaced with understanding, regulation becomes much more possible.
“You are allowed to be both a masterpiece and a work in progress simultaneously.”
— Sophia Bush
Listening to Understanding — Not Assumptions
Over the years I have learned that many people will have opinions about what they believe is “wrong” with us. Sometimes those opinions come from concern. Sometimes they come from misunderstanding. And sometimes they come from people simply trying to make sense of behavior they do not fully understand.
“Don’t judge me based on your ignorance.”
— Healthy Place
I know there are people in my life who worry about why I still experience certain struggles — such as memory issues, speech changes under stress, or emotional reactions in difficult situations. But I have learned to place my trust in professionals who actually study how the brain works.
Through therapy, continued education, and research, I have gained a much deeper understanding of how ADHD, anxiety, and CPTSD interact neurologically. And these type of reactions are actually normal. Understanding does not eliminate the challenges. But it does make them far easier to navigate.
“Healing doesn’t mean the damage never existed. It means the damage no longer controls your life.”
— Akshay Dubey
Closing: Understanding the Hot Mess (In Summary)
Living with what I jokingly call my “Perfect Hot Mess Trifecta” — ADHD, severe anxiety, and CPTSD — is not always easy to explain, especially in the moment when emotions are already high, which is when I usually have the “need” to explain it.
From the outside, some reactions may appear confusing or inconsistent. But when you understand the neurological processes behind those reactions, they begin to make much more sense. When these systems activate at the same time, the brain can feel like it is managing multiple competing signals all at once. What may appear from the outside as overreacting, distraction, or inconsistency is often the nervous system simply trying to regulate itself.
Understanding that has been one of the most important parts of my healing. The more I learned about how the brain works, the more I was able to replace shame with awareness and frustration with regulation.
There will always be people who have their own assumptions about what they think is happening or why someone reacts a certain way. But what many people see as a reaction can often be a nervous system trying to survive something it has not fully healed from yet.
Understanding creates healing. Judgment only creates more damage.
“Mental illness is nothing to be ashamed of, but stigma and bias shame us all.”
— Healthy Place
Appendix: Symptom Overlap in My “Hot Mess Trifecta”
(ADHD, Severe Anxiety, and CPTSD)
The following are some of the symptoms that can occur when these three conditions interact. These reactions do not always appear individually — they often overlap and amplify each other.
Cognitive (Thinking & Memory)
These symptoms affect how the brain processes and organizes information.
- Difficulty concentrating
- Losing train of thought mid-conversation
- Forgetting things that were just discussed
- Trouble organizing thoughts
- Decision paralysis
- Racing thoughts combined with mental fog
- Difficulty prioritizing tasks
- Feeling mentally overwhelmed
- Time blindness
- Trouble finishing tasks even when they are important
Emotional Regulation
These symptoms relate to how the brain processes emotional stress.
- Emotional overwhelm
- Strong reactions to criticism
- Irritability when overstimulated
- Feeling easily triggered by certain topics or tones
- Heightened sensitivity to conflict
- Emotions escalating quickly in stressful situations
- Difficulty calming down once upset
- Increased self-criticism or shame after reactions
Nervous System / Stress Response
These symptoms come from the brain’s threat detection system being activated.
- Hypervigilance (constantly scanning the environment)
- Difficulty relaxing
- Feeling “on edge”
- Physical tension in the body
- Difficulty shutting off the brain at night
- Fatigue from prolonged stress
- Startle response to sudden stimuli
- Feeling mentally exhausted but unable to rest
Executive Function Challenges
These come mostly from the ADHD component but often worsen under stress.
- Task paralysis
- Starting many things but finishing few
- Difficulty switching between tasks
- Forgetting important details
- Losing items frequently
- Disorganization
- Difficulty following multi-step instructions
Social / Communication Effects
These symptoms are often the most misunderstood.
- Losing words during stressful conversations
- Difficulty expressing thoughts clearly under pressure
- Speech becoming disorganized when overwhelmed
- Avoiding difficult conversations due to anxiety
- Appearing distracted in conversations
- Misinterpreting tone or perceived criticism
Research & Educational Sources
Then include:
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).
National Institute of Mental Health (NIMH). Research and information on ADHD, anxiety disorders, and PTSD.
Arnsten, A. (2009). Stress signalling pathways that impair prefrontal cortex structure and function. Nature Reviews Neuroscience.
McEwen, B. (2007). Physiology and neurobiology of stress and adaptation. Physiological Reviews.
Bremner, J. (2006). Traumatic stress and the brain. Dialogues in Clinical Neuroscience.
Bush, G., Valera, E., & Seidman, L. (2005). Functional neuroimaging of ADHD. Biological Psychiatry.
van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma.
National Institute of Mental Health. Trauma and stress response research.
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